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Pre-recorded Webinar (Get instantly)
Presented By Jill M. Young
Session Description
CMS/Medicare and CPT have been in different places with their definition of "substantive portion" for a split shared visit. It was anticipated that in 2024 CMS/Medicare would again have a different way of looking at which provider can bill this type of joint service when done in a facility setting. The PFS Final rule surprised many as CMS/Medicare said they would be following the new clarified policy set forth in CPT's 2024 code book. What is this new definitions of "substantive portion" and what does it mean for your NPs and PAs working in the hospital and other facility based locations? Listen in and learn. Bring your questions with you
The rules of billing for Nurse Practitioners and Physician Assistants can be confusing and challenging. Each payer can have their own definitions for direct and indirect billing of their services. Comparing these rules reveals a diverse and oft times confusing list of what compliant billing of these provider’s indirect services entails.
CMS has been transitioning their definition of split/shared visits for the past few years in calling for a substantive portion of the work to be done by the billing provider while allowing an alternative definition. Although this has been extended until the end of 2024, CPT®’s new definition causes much discussion on where their rules would fall into place with CMS'.
Session Objectives
Compliant billing of Non-physician Practitioners (NPPs) is no easy task. Dealing with differing sets of payer rules can give coders and billers fits. This session is intended not only to present a simplified view of NPP billing, but also to show how the updated guidelines CPT® has defined will integrate into this landscape.
Session Agenda
2024 CPT® updates to split shared billing. what we know today about this new definition from the AMA and how they see the day-to-day documentation changes needed to meet it.
Split shared billing’s definition from CMS’ perspective. What challenges are presented in the differing words of each
Session Highlights
Pre-recorded Webinar (Get instantly)
Presented By Toni Elhoms
Session Description
Split/shared services are one of the most misunderstood categories of billing and reporting. For evaluation and management (E/M) visits jointly furnished by a physician and NPP in the same group practice in a facility setting, CMS has historically allowed the visit to be billed under the physician's NPI. However, all of that changed in 2022 and 2023 (transitional years) with updated rules that disallowed this practice and required the visit to be billed under the NPI of the physician or NPP who either documents the history, exam, or medical-decision-making for the visit OR whoever provides more than 50% of the total service time. In 2024, the changes are even more drastic, now requiring the visit to be billed under the NPI of the individual who provides more than 50% of the total visit time. This changes everything about how these encounters are billed and dramatically impacts physician RVU allocation. The 2024 split/shared service updates will have a massive impact on providers' clinical documentation and reimbursement rates.
Join us for this information-packed webinar by Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer, and take a deeper dive into the 2024 split/shared service updates along with the discussion on the proper application of the 2024 guidelines, clinical documentation requirements, and dissect clinical documentation scenarios to map out how this will look for medical practices in 2024.
Session Objectives
The session aims to provide insights into the new 2024 split/shared visit rules in the facility setting, as announced by the Centers for Medicare & Medicaid Services (CMS). These groundbreaking changes are set to have a substantial impact on Medicare reimbursement, affecting both hospital-employed providers and physician practices utilizing non-physician practitioners (NPPs) in the facility setting.
Session Agenda
Session Highlights
Who Should Attend
Jill M Young is the Principal of Young Medical Consulting, LLC. A company founded 18 years ago to meet the education and compliance needs of physicians and their staff Jill has over 40 years of medical experience working in all areas of the medical practice including clinical, billing and rounding with physicians. Her unique style of working with physicians is not only effective but helps bridge the gap between coders and physicians from a practical perspective. Her comments and opinions can be seen in several publications and also heard on a variety of audio-conferences. Her background gives her a unique style of teaching using real life examples of coding and…
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Toni Elhoms, CCS, CRC, CPC, AHIMA-Approved ICD10-CM/PCS Trainer is a nationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various…
Read More| Date | Conferences | Duration | Price | |
|---|---|---|---|---|
| Dec 12, 2024 | 2025 CPT Code Changes: What You Need to Know | 60 Mins | $199.00 | |
| Nov 26, 2024 | Non Physician Practitioner Updates for 2025 – What NP’s and PA’s need to know for 2025 | 60 Mins | $199.00 | |
| Oct 08, 2024 | Unlocking 2025 ICD-10-CM, Medicare Revalidation, and Denial Success: A Strategic Guide for Healthcare | 180 Mins | $399.00 | |
| Sep 26, 2024 | ICD-10-CM Updates and Credentialing Tips: Mastering Medicare Revalidation | 180 Mins | $399.00 | |
| Sep 24, 2024 | ICD-10-CM Updates for 2025 | 60 Mins | $199.00 | |
| Aug 13, 2024 | Split Shared in 2024 - What CPT Changes mean vs Medicare's rules | 60 Mins | $199.00 | |
| Jul 30, 2024 | Auditing Office E&M Services – Is it a Level 3 or Level 4? | 60 Mins | $199.00 |