2023 Gastroenterology Reimbursement and Coding Update (On-Demand) | November 2022-2022/2023 Split-Shared CMS Guidelines and Documentation Requirements

2022/2023 Split-Shared CMS Guidelines and Documentation Requirements

Video Transcription

Video Summary

In this video, the speaker discusses the CMS guidelines regarding split share visits. They explain that split share visits are medically necessary encounters where both a physician and a non-physician practitioner (NPP) perform a substantive portion of an E&M visit with the same patient. The billing provider must be the one who performed the substantive portion. The speaker emphasizes the importance of identifying who performed each part of the visit in the documentation. They mention that billing under the physician results in 100% reimbursement, while billing under the NPP results in 85% reimbursement. The speaker also discusses the documentation requirements for split share visits, including the use of a modifier on the claim. They provide clinical examples and answer common questions about the billing and documentation process for split share visits. The speaker also mentions that split share visits are no longer allowed in the office setting according to CMS.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

CMS guidelines

split share visits

physician

non-physician practitioner

E&M visit