Medical Billing For Non-Physician Practitioners

Medical Billing For Non-Physician Practitioners

Medical billing policies by non-physician practitioners have recently changed. The Centers for Medicare & Medicaid Services reduced restrictions on what types of providers can bill for medical services. There are now several instances when a CMS and NPP can do medical billing for the services they provide.

There are several medical billing scenarios to clarify for non-physician practitioners. First of all, it is perfectly legitimate for a nurse practitioner or a clinical nurse specialist to get reimbursed for services rendered in the skilled nursing facility in which they are employed. If the non-physician practitioner decides to resign their payments to the facility, then the SNF can bill under Medicare Part B, but use the nurse’s UPIN. In this instance, billing is only allowed for medical services to facility residents.

Another scenario is when the nurse practitioner or clinical nurse specialist employed by a skilled nursing facility does medical billing for services directly. This means that the nurse would not bill through the facility that employs him/her. Unfortunately, the only way a physician assistant can get payment for services in a skilled nursing facility is to bill through that facility. They must always use Medicare part B services and the PA’s UPIN.

PA’s, NP’s, and CNS’s do have a little more freedom, however. It is no longer necessary for a physician to sign orders by these non-physician practitioners. If they decide not to have their notes signed off, they must remember that physicians can still be held responsible for treatment. As with everything else, if the State law requires anything other then this federal regulation, the state law trumps the medical billing rule.

In the past it was very difficult to do medical billing for non-physician practitioners. Now medical billing will be made a little simpler by allowing ease in payment for these non-physician practitioners.

View all Articles by: Melissa Clark, CCS-P