Part B News | NPP Report

PAs, NPs rising: Recent rules enhance stature, profile and maybe pay

12/20/2021

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerly known as mid-levels and extenders are increasingly important to U.S. health care. For medical groups, they may cost more to employ in the years to come.

For E/M, initial NPP-only visit counts — unless there’s no professional service

08/26/2019

by: Roy Edroso

Question: A new patient came in and saw our physician assistant (PA) for some lacerations. She did not see a doctor. A week later the patient returned for follow up with an M.D. For purposes of billing the E/M, is the doctor visit a new patient visit or an established patient billing?

CMS proposes to loosen supervision requirements for PA, CRNAs

08/12/2019

by: Roy Edroso

Some non-physician practitioners (NPPs) and the practices that increasingly rely on them are set to get a break from CMS in 2020, should significant scope-of-practice updates in the proposed 2020 Medicare physician fee schedule take hold.

MedPAC call to end incident-to no isolated threat — but will CMS lower the boom?

07/08/2019

by: Roy Edroso

Medical practices that use non-physician practitioners (NPPs) may have gotten a little nervous last month when the Medicare Payment Advisory Commission (MedPAC) proposed the end of incident-to billing. Whether CMS accepts the proposal or not, other signs are showing that the feds would like to get all NPP services reimbursed at 85% of the physician rate, regardless of incident-to status.

SSA urged to give more weight to NPP findings for disability claims

10/25/2013

In perhaps another sign of the growth in services furnished by non-physician practitioners, the SSA is being asked to give equal weight to the medical findings of NPPs when determining whether a person is eligible for Social Security disability payments.

Ensure proper NPP documentation of AWV and E/M on same day

10/29/2012

by: Ben Penn

Don’t risk a denial when your non-physician providers bill an annual wellness visit (AWV) and E/M service for the same patient on the same day. Maintain separate documentation of the two components of the visit – one that fulfills the AWV and one that addressed the patient’s unrelated complaint.

OIG targets NPP billing, incident-to and payments in 2013 Work Plan

10/29/2012

by: Lauren C. Williams

Expect the same scrutiny of your non-physician practitioners’ (NPPs’) billing and payments from HHS’ Office of Inspector General (OIG) can as their physician counterparts. Review all six audit targets for NPP services on the OIG's 2013 Work Plan.

NPP Benchmark: NP, PA established patient E/M utilization

10/29/2012

by: Ben Penn

These charts represent the E/M utilization for established patient codes (99211-99215) in 2009, 2010 and 2011 for both physician assistants (PAs) and nurse practitioners (NPs). The utilization for each code is presented from left to right in order of 2009-2011. All numbers come from a Part B News analysis of Medicare claims data.

Ease NPPs into your practice for optimum work environment, efficiency

08/27/2012

by: Ben Penn

Don’t rush the non-physician practitioner (NPP) hiring process if you want to see the intended workflow efficiencies and financial results. Thorough research of state laws and NPP credentials, complete physician buy-in and clearly delegated tasks are all necessary before you bring on these new providers.

CMS proposes expansion of mobile X-ray ordering to NPPs, podiatrists

08/27/2012

by: Lauren C. Williams

Instruct non-physician practitioners (NPPs) to justify orders for portable X-ray services with written statements about the patient’s need to avoid denials and survive audits. CMS has proposed to expand its policy on who can order mobile X-ray services from just physicians to include podiatrists, dentists and NPPs, according to the proposed 2013 Medicare physician fee schedule.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.