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NPP Report
06/25/2012

This chart shows the denial rates for five nurse physician practitioner (NPP) specialties for E/M office visits, based on 2010 Medicare claims data. For each specialty, the denial rates of level 3, level 4 and level 5 E/M office visits is depicted, based on a combination of E/M codes billed for initial patient visits and subsequent patient visits (99203-99205 and 99213-99215).

05/21/2012

Your doctors may get a break from hospital rounds, thanks to a CMS rule that grants non-physician practitioners (NPPs) the same hospital privileges. The hospital and critical access hospital reform final rule, released May 9, counts NPPs such as advanced practice registered nurses (APRNs) and physician assistants (PAs) as part of medical staff giving them the power to use their licensed skills in hospitals.

05/21/2012

A recent report from the HHS Office of the Inspector General (OIG) showing a rise in higher-level E/M coding selection over the past decade includes nurse physician practitioners (NPPs) among the possibly suspicious physicians who consistently bill a level 4 or level 5.

05/21/2012

This chart shows the breakdown of specialties among the nearly 1,700 physicians who billed either a level 4 or level 5 for at least 95% of all their E/M codes in 2010. The 1,700 consistently high-billing doctors were chronicled in an HHS Office of the Inspector General (OIG) report released this month.

04/30/2012

A change to the therapy cap calculation means more work for practices starting Oct. 1.

CMS will count therapy a patient received in a hospital outpatient department toward the cap, set in 2012 at $1,880 for occupational therapy and $1,880 for physical and speech therapies, said Stewart Streimer, director of CMS’s provider billing group during an April 17 call. CMS will not reprocess claims, but, starting Oct. 1 it will recalculate a patient’s services toward the therapy cap amount retroactive to Jan. 1, he said.

04/30/2012

Keep an eye on reimbursement policies for physician assistants and nurse practitioners and be ready to work with physician hospital organizations to prevent improper payments and compliance errors.

A private payer that doesn’t credential non-physician practitioners may allow you to bill your NPPs’ services under the physician’s national provider identifier (NPI). The payer might not require a supervising physician to be in the office suite during the service or visit. In this case the practice is able to receive the full fee schedule amount for the NPP’s work and the physician is free to provide other services.

04/30/2012

This chart shows the turnover rates last year of two types of non physician practitioners (NPPs) – physician assistants (PAs) and nurse practitioners (NPs). All data comes from the 2011 Physician Retention Survey, a joint effort of the American Medical Group Association (AMGA) and Cejka Search, a health care recruitment company.

02/27/2012

You may be missing out on extra Medicare reimbursements for new preventive services simply because your physicians still don’t realize – two months into 2012 – that their non-physician practitioners (NPPs) can assume the majority of the workflow.

02/27/2012

You and your peers lose tens of millions of dollars in incident-to service denials due to improper physician supervision. The crux of NPP billing regardless of whether it’s incident-to or not lay with proper supervision. Review each types of supervision and each scenario detailing where a doctor must be physically for an NPP to render specific services.

02/27/2012

This chart, from the 2010 American Academy of Physician Assistants Census, represents the annual median compensation for physician assistants (PAs) broken down by seven specialty types. NOTE: Survey data was collected between October 2010 and April 2011 and represents nearly 20,000 clinically practicing PAs, or almost a quarter of the total PA workforce. 

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