Billing for Nurse Practitioners in 2022

Jill M. Young

Jill M. Young

Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working...
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120 Mins
Jill M. Young

Understanding Medicare’s “incident to” billing concept and how it has changed during the PHE

As the physician shortage continues to increase, nurse practitioners are looked at more and more as a solution and valuable commodity as alternative providers. Observational studies have shown that patients often prefer Nurse Practitioners to Physicians in a Primary Care setting.

These individuals who were highly trained nurses, chose to receive additional training to become nurse practitioners (NP). State Scope of Practice defines what they can do which is not pandemic public health emergency (PHR) times. In some states, prescriptive authority is an issue, in other states the level of supervision for patient care is higher than published Medicare standards. Knowing what your State requirements are is a must as a foundation for the knowledge you need to build your compliant practice plan for the use of your Nurse Practitioner. Other factors in building (or evaluating your practice plan include how to utilize NP’s in differing healthcare settings and analyzing the varying levels of supervision required at these locations.  Collaborative Care agreements also need to be in writing and analyzed and updated periodically, especially with any practice or job description changes.

Lastly, the significant changes in Split Shared billing for 2022, need to be understood at a very detailed level. Compliance with these new policy changes for Medicare and all insurances that follow Medicare rules for these services is a must! The changes to Split Shared services, also affect both Critical Care services and teaching services, so significant learning is needed to make sure your practice plan doesn’t collapse like a house of cards under the weight of an audit! One more question, did Medicare’s policy change to Physician Assistant’s services have any effect on Nurse Practitioner services? Join this webinar by our expert speaker Jill M Young to understand these changes.

Webinar Objectives

  • Understanding state scope of practice differences and how to look up yours
  • Understanding Medicare’s “incident to” billing concept and how it has changed during the PHE
  • What documentation is needed to meet the requirements of it
  • Understanding Medicare’s concept of direct billing and what that means for the NP
  • Understanding why Medicare’s Physician’s Relative Value Fee Schedule Data Base is so valuable
  • Understanding what payment policies are for Nurse Practitioners    
  • Understanding the significant changes to Split Shared Billing for 2022
  • What has all this to do with other commercial insurances?

Webinar Agenda

  • State Scope of Practice – What is it?  Where to Find it? How do understand it?
  • Introduction to Medicare’s Policy for Nurse Practitioner’s Billing – (payment policies, collaborative agreements)
  • Introduction to Medicare’s policies for Incident to and Direct Billing (supervision requirements)
  • Understanding Medicare’s Physician’s Relative Value Fee Schedule DataBase
  • Medicare and Nurse Practitioners During the Public Health Emergency (PHE)
  • Changes to policies in 2022 (Split Shared Visits, Critical Care, Defining Teaching Services, Diagnostic Testing. Changes to Physician Assistant’s Services)

Webinar Highlights

  • State Scope of Practice Restrictions
  • Incident To and Plan of Care Restrictions
  • Levels of Supervision and Temporary Changes during the PHE
  • Commercial insurances diverse policies
  • Split Shared Changes in 2022

Who Should Attend

  • Billers
  • Officer Manager
  • Office Administrators
  • Practice managers
  • Nurse Practitioners
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