The rules of billing for Nurse Practitioners and Physician Assistants can be confusing and challenging. Each payer can have their own definitions for direct and indirect billing of their services. Comparing these rules reveals a diverse and often times confusing list of what compliant billing of these providers’ indirect services entails. 

CMS has been transitioning its definition of split/shared visits for the past few years in calling for a substantive portion of the work to be done by the billing provider while allowing an alternative definition. Although this has been extended until the end of 2024, CPT’s new definition causes much discussion on where their rules would fall into place with CMS.

Compliant billing of Non-physician Practitioners (NPPs) is no easy task. Dealing with differing sets of payer rules can give coders and billers fits. This session is intended not only to present a simplified view of NPP billing but also to show how the updated guidelines CPT has defined will integrate into this landscape.

• The new guidelines for split shared visits found in CPT® 2024
• CMS’ guidelines for split shared in2024
• CMS’ guidelines for incident to
• Other payers’ rules and regulations for Non-Physician Practitioner billing

2024 CPT® updates to split shared billing.  what we know today about this new definition from the AMA and how they see the day-to-day documentation changes needed to meet it. Split shared billing’s definition from CMS’ perspective.  What challenges are presented in the differing words of each?

• Coders
• Billers
• Office Managers
• Office Administrators
• Nurse Practitioners
• Physician Assistants