Nonphysician Practitioner Reference Guide - eBook - Third Edition

Ensure full pay for services provided by your nurse practitioners, physician assistants, clinical nurse specialists, and other mid-level clinicians.

Staffing nonphysician practitioners (NPPs) enables your practice to see more patients, but the revenue benefits depend on your team’s ability to navigate the complex set of NPP coding and billing rules.

Do you know the guidelines that Medicare and other payers apply toward reimbursement of NPP services? Are you clear on the rules for direct supervision? How about reciprocity? If you’re like most, you have more questions than answers.

Getting incident-to billing right means 15% more in reimbursement. Getting it wrong could be considered fraudulent. With stakes this high, you need the Nonphysician Practitioner Reference Guide. 

This comprehensive resource provides expert guidance covering the scope of NPP coding and billing regulations. Understand the distinctions between shared visit and incident-to services and meet the troublesome requirements of audit-ready incident-to billing.

Packed with authoritative tips, readers’ Q&A, and handy clip-and-save tools—including an incident-to audit checklist—you’ll master the reporting nuances of E/M services, prolonged services, virtual visits, and more.

 Shore up revenue for your mid-level practitioners with:

• Understand the 2023 E/M code and guideline changes
• Tips for accurate dual-provider coding
• Max out incident-to pay the right way and earn 100% of allowable revenue versus 85%
• Rely on split/shared visit coding in non-office settings
• Know how to avoid substitute physician billing challenges
• Boost your signature know-how and avoid claim denials
• Watch incident-to claims when physician is out of office
• Get the facts on performing consults
• Learn the secret NPP guidelines for coding virtual visits
• And much more!

Clear up your NPP compliance confusion—and know exactly when you can bill service incidents to the physician—with the Nonphysician Practitioner Reference Guide.

IMPORTANT NOTE: If you already have the first or second edition of the Nonphysician Practitioner Reference Guide, you will want to upgrade to the third edition, which includes updates for the E/M code and guidelines changes that occurred in 2023. This new edition removes deleted CPT^® codes, replaces official descriptors for all revised CPT^® codes, and offers coding and billing tips for NPPs using home services codes.

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