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NPP Report
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. 

02/23/2012

Can dietitians and nutritionists bill services “incident-to” if they operate out of a physician practice? If so, can the nutritionist bill under the physician that is onsite that day and is different than the patient’s primary care provider for the new obesity counseling service? Also, what services can the dietitians bill “incident-to” and what supporting documentation is needed?

01/30/2012

Your physician assistants (PAs) may now certify and recertify patients for Skilled Nursing Facility (SNF) services, CMS announced in a transmittal earlier this month.

Rather than wait on the physician to get back to the office to sign off on the SNF transfer, PAs can go ahead and certify on their own, facilitating a much smoother process for the practice and the patient, says Michael Powe, vice president of reimbursement and professional advocacy for the American Academy of Physician Assistants (AAPA).

01/30/2012

This chart presents five wound care codes and their corresponding denials as a percentage of overall service count for both physician assistants (PAs) and nurse practitioners (NPs). Data was taken from 2009 and 2010. NOTE: Wound vac codes were excluded from this graph.

01/27/2012

Medicare has stopped paying our administration-only injection claims citing that a qualifying procedure code/service is needed. What is the proper way to bill just the administration code for patients who bring in their own medication (e.g., B-12 shots, testosterone injections)? We have only billed 96372 (therapeutic, prophylactic, or diagnostic injection).

12/19/2011

Your non-physician practitioners (NPPs) will play leading roles in providing three newly covered services in 2012: screening and counseling for obesity, alcohol misuse and depression. These conditions are currently addressed as part of an office visit and you don’t get any separate reimbursement for them, experts say.

12/19/2011

You can optimize your practice’s time by knowing when to it’s ok bill non-physician practitioner (NPP) services under your physician’s national provider number (NPI) outside of billing incident-to. While your NPPs can’t bill under the doctor’s NPI for major services such as E/M visits without meeting all of the incident-to requirements or billing under their own number, there are threekey scenarios in which you can that will optimize physician and staff time, experts say.

12/19/2011

These charts show 10 codes billed by non-physician practitioners (NPPs) that have relatively low denial rates, but were responsible for a major chunk of lost reimbursement in 2010. The top chart shows the average dollar amount lost per single denial in 2009 and 2010, while the bottom chart shows the average denial rate. NOTE: For the purpose of this analysis, NPPs include certified nurse midwives, certified registered nurse anesthetists (CRNAs), chiropractors, clinical nurse specialists, nurse practitioners, physician assistants and physical therapists. CMS does not distinguish between physician-billed services and those billed incident-to by NPPs, so this data excludes incident-to services.

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