2022 Billing for Nurse and Physician Practitioners update - During the PHE and with Updated Medicare Guidelines

Session 1- Billing for Physician Assistants in 2022 – During the PHE and with Updated Medicare Guidelines and New Split Shared Guidelines

Physician Assistants (PA) are more prevalent than ever in practices both primary care and surgical. They have proven themselves to be a valuable, productive addition to the provider group in an office.

During the Public Health Emergency (PHE), supervision requirements have changed per Medicare/CMS rules, allowing them to work even more autonomously. Is your practice utilizing your PA to the fullest extent it can? What will happen once the PHE is over? Which of the changes implemented will become permanent?

Each state has a defined Scope of Practice for a practicing Physicians’ Assistant. These can be very different from state to state, including allowances for prescriptive authority. Levels of supervision required for differing services need to be identified and followed to remain compliant. Collaborative care agreements can also be a consideration.

The Medicare Physician Fee Schedule Final Rule for 2022, has significant changes for split and shared services beginning in 2023. For 2022, a hybrid of the new rules is being utilized. Understanding what is needed for 2022 and what difference is required in 2023 is a must for practices that want to utilize PAs to their full extent allowed.   

Webinar Objectives

• Understanding state scope of practice differences and how to look up yours
• Understanding the significant changes to Split Shared Billing for 2022 and 2023
• Understanding Medicare’s “incident to”  and levels of supervision including what has changed during the PHE
• What documentation is needed to meet the requirements of it
• Understanding Medicare’s concept of direct billing and what that means for the Physician Assistant
• Understanding why Medicare’s Physician’s Relative Value Fee Schedule Data Base is so valuable
• What payment policies are enacted for Physician Assistant services for differing Medicare services?
• What has all this to do with other commercial insurances? 

Webinar Agenda

• State Scope of Practice – What is it?  Where to Find it? How do understand it?
• Introduction to Medicare’s Policy for Physician Assistant Billing – (payment policies, collaborative agreements)
• What changes were made for Physician Assistant services by Medicare in 2022?
• Introduction to Medicare’s policies for Incident to and Direct Billing (supervision requirements)
• Understanding Medicare’s Physician’s Relative Value Fee Schedule DataBase
• Medicare and Physician Assistants During the Public Health Emergency (PHE)
• Changes to policies in 2022 (Split Shared Visits, Critical Care, Defining Teaching Services, Diagnostic Testing) 

Webinar Highlights

• State Scope of Practice Restrictions
• Incident To and Plan of Care Restrictions
• Direct Billing 
• Levels of Supervision and Temporary Changes during the PHE
• Commercial insurances diverse policies
• Split Shared Changes in 2022

Session 2 – Billing for Nurse Practitioners in 2022 – During the PHE and with New Split Shared Guidelines

As the physician shortage continues to increase, nurse practitioners are looked at more and more as a solution and valuable commodity as alternative providers. Observational studies have shown that patients often prefer Nurse Practitioners to Physicians in a Primary Care setting. 

These individuals who were highly trained nurses, chose to receive additional training to become nurse practitioners (NP). State Scope of Practice defines what they can do which is not pandemic public health emergency (PHR) times. In some states, prescriptive authority is an issue, in other states the level of supervision for patient care is higher than published Medicare standards. Knowing what your State requirements are is a must as a foundation for the knowledge you need to build your compliant practice plan for the use of your Nurse Practitioner. Other factors in building (or evaluating your practice plan include how to utilize NP’s in differing healthcare settings and analyzing the varying levels of supervision required at these locations.  Collaborative Care agreements also need to be in writing and analyzed and updated periodically, especially with any practice or job description changes.

Lastly, the significant changes in Split Shared billing for 2022, need to be understood at a very detailed level. Compliance with these new policy changes for Medicare and all insurances that follow Medicare rules for these services is a must! The changes to Split Shared services, also affect both Critical Care services and teaching services, so significant learning is needed to make sure your practice plan doesn’t collapse like a house of cards under the weight of an audit! One more question, did Medicare’s policy change to Physician Assistant’s services have any effect on Nurse Practitioner services? Join this webinar by our expert speaker Jill M Young to understand these changes. 

Webinar Objectives

• Understanding state scope of practice differences and how to look up yours
• Understanding Medicare’s “incident to” billing concept and how it has changed during the PHE
• What documentation is needed to meet the requirements of it
• Understanding Medicare’s concept of direct billing and what that means for the NP
• Understanding why Medicare’s Physician’s Relative Value Fee Schedule Data Base is so valuable
• Understanding what payment policies are for Nurse Practitioners    
• Understanding the significant changes to Split Shared Billing for 2022
• What has all this to do with other commercial insurances? 

Webinar Agenda

• State Scope of Practice – What is it?  Where to Find it? How do understand it?
• Introduction to Medicare’s Policy for Nurse Practitioner’s Billing – (payment policies, collaborative agreements)
• Introduction to Medicare’s policies for Incident to and Direct Billing (supervision requirements)
• Understanding Medicare’s Physician’s Relative Value Fee Schedule DataBase
• Medicare and Nurse Practitioners During the Public Health Emergency (PHE)
• Changes to policies in 2022 (Split Shared Visits, Critical Care, Defining Teaching Services, Diagnostic Testing. Changes to Physician Assistant’s Services)

Webinar Highlights

• State Scope of Practice Restrictions
• Incident To and Plan of Care Restrictions
• Levels of Supervision and Temporary Changes during the PHE
• Commercial insurances diverse policies
• Split Shared Changes in 2022

Who Should Attend:

• Coders
• Billers
• Officer Manager
• Office Administrators
• Physician Assistants
• Nurse Practitioners