Incident-to and split/shared visits continue to bedevil non-physician practitioners (NPPs), with denials particularly high for physical therapists. But it doesn't have to be this way, experts say. If you take the time to learn and understand the definitions and requirements for both types of billing, you'll boost your reimbursement and lower your compliance risks by following the rules.

You may be able to overturn a scope-of-practice denial immediately by contacting your carrier directly, experts say.

This chart shows how having NPPs in a practice affects key measures of practice productivity, including earned revenue, improved physician productivity and increases in the patient base.

This week's question is answered by Sean Weiss CPC, vice president of DecisionHealth Professional Services.

Q.   Can a nurse practitioner (NP) bill under his or her own National Provider Identifier for some services and "incident-to" on the same date of service depending on the type of services they provide?

The National Organization of Nurse Practitioner Faculties (NONPF) has identified several portions of the American Recovery & Reinvestment Act of 2008 (ARRA) that will "... help nurse practitioners provide quality, cost-effective care to communities across the country," the NONPF says in a press release.

Solo practitioners who enrolled in Medicare before November 2003 won't be able to access their 2007 Physician Quality Reporting Initiative (PQRI) feedback report until they update their enrollment data through CMS's online enrollment system, the agency said.

An upstart practice figured out which of its insurance payers provided the highest reimbursement for services. Physicians in the practice wanted to build a larger patient base with that insurance carrier and decided to spend two days administering flu shots -- charging only its cost -- at a company offering the insurance to its employees. 

The 2009 Physician Quality Reporting Initiative (PQRI) reporting period has already seen its fair share of code and measure-related errors (PBN 3/30/09), but CMS admitted the existence of another set of errors during an April 22 open door call -- this time pertaining to radiation therapy codes for prostate cancer.

The Senate Finance Committee and a roundtable of experts hashed out the pros and cons of reforming the healthcare delivery system, including bundling more of your payments and encouraging coordinated care.