Your physicians can bill Medicare for annual wellness visits (AWVs) that were performed by one or more non-physicians, such as nurse practitioners and registered nurses, so long as they provided direct supervision. Confusion arose over whether AWVs can be billed in this way, which gives you the full Medicare fee schedule payment; a nurse practitioner or other non-physician practitioner (NPP) billing under their own identifier would be paid at 85% of the fee schedule rate.

The health reform law has given you and your peers more billing opportunities that will boost your revenue but likely crowd your schedule. Non-physician practitioners (NPPs) can render these services along with the annual wellness visit, leaving physicians to concentrate on higher-value, more complex services, experts tell NPP Report.

These charts analyze the difference between nurse practitioners (NPs) and physician assistants (PAs) in terms of their Medicare utilization and denial rates, separated by code type (as defined by code ranges). All data is based on CMS claims data from 2009.  Overall, while medicine codes are the greatest area of utilization for both NPs and PAs, the utilization data clearly shows NPs bill more medicine codes and fewer surgeries, whereas PAs exhibit the opposite trend.

Q. We have several physicians and two nurse practitioners. Are the nurse practitioners NPI’s are also being tracked like the physicians for e-prescribing? Can they receive a bonus?

Accountable care organizations (ACOs) are supposed to cost Medicare less money while improving patient outcomes at the same time – with you and your peers getting a big chunk of the savings. But this isn’t guaranteed, while CMS’s proposed ACO rule would force you to share a portion of potential losses as well over the three-year timeframe of the program.

You and your peers all want to secure $18,000 per provider in federal electronic health record (EHR) incentive bonuses by the end of 2012, a desire that will overwhelm the relatively young EHR vendor industry, experts tell Part B News. Take these five steps now to ensure your practice gets what it needs to earn $18,000 per provider by the end of 2012.

The technical component (TC) of your advanced imaging claims will be denied if you fail to get accredited for every CPT code you bill, and enrollment could prove tedious and time consuming, experts tell Part B News. Unaccredited technical components of advanced medical imaging services billed for services furnished on or after Jan. 1, 2012 will be denied, a CMS official says. 

There is no distinct service or visit code to pay you directly for end-of-life planning. And you’re no longer required to offer patients a chance to discuss it, since that’s been dropped from the annual wellness visit. But you may be able to ratchet up your revenue if you have these discussions with patients by reporting them under the Physician Quality Reporting System (PQRS).

This chart looks at how denial rates for top-dollar, high-utilization imaging services are impacted by the place of service (POS). NOTE: A total of four POS codes were used, office (11), outpatient hospital (22), inpatient hospital (21) and emergency room (23). These were combined into inpatient/emergency room and outpatient/office to make the data more accessible at a glance. NOTE: The imaging codes were chosen based on a combination of their annual Medicare utilization and total value in Medicare dollars paid, based on CMS claims data from 2009.