Boost Practice’s Revenue: Navigate CMS Split/Shared and Incident-To Billing Changes

Course Description:

The term Split or shared visits used by the Center for Medicare & Medicaid Services (CMS) allow non-physician practitioners (NPPs) and physicians who work for the same employer/entity to share patient visits on the same day by billing the combined work under the physician’s National Provider Identifier (NPI) and receive 100% of the Medicare Physician Fee Schedule (MPFS), or the NPP’s NPI for reimbursement of 85% of the MPFS. This webinar will get the crux of understanding split or shared billing. CMS stated they will no longer accept the typical attestation for when a physician has a collaborative agreement to round in the inpatient setting. They now recently finalized and revised their rule on how to meet the “substantive portion” of the visit which also includes a medical decision. Don’t get caught up with not understanding what this means and how this could affect your reimbursement or much worse, put you at risk of being audited.

Learning Objectives:

Define Split/Shared Services and “Incident To” definitions
What is the substantive portion?
What is CMS’ definition of facility?
Compare Incident to services with Split/Shared Services
How CMS will determine when Split/Shared Services are billed?
Key elements to the Evaluation and Management MDM Table as it related to the substantive portion in your hospital rounding
Understanding how collaborative agreements work with Facility Based Services
Learn how the Federal Register has updated CMS’s determination of the substantive portion
Know how different MAC’s are being transparent with their expectations of documentation of Split/Shared services

Areas Covered in the Session:

CMS New Split/Shared Services and “Incident To” definitions
What does CMS mean by Facility?
What is the difference between Split/Shared and incident to billing?
“Incident-To” Documentation vs. Split/Shared Billing Documentation
What is the substantive portion?
Table of Substantive Portion for E/M Portion Code Families in Split/Shared billing
Will CMS know when Split/Shared services are billed?
Does this new Split/Shared rule affect reimbursement?
Split/Shared Documentation APP/Physician Reimbursement Table
How CMS will determine when Split/Shared Services are billed?
Split/Shared Documentation Examples for current Rules
Split/Shared Documentation Examples for the Past Rules
What is the best way to document?
What is considered substantive?
Split/Shared Time-based billing
EM documentation requirements
Would this change how notes are attested?
Preferred Attestation Language
Time Affecting Teaching Physicians in the Office Based Setting
Split/Shared Billing for Prolonged Services
New Updates Split/Shared Services
CMS MAC Updates Split/Shared Services
Table for reporting Prolonged Split/Shared Visits
CMS Final Rule Split/Shared Services Attestation Questions and Examples
Summation of documentation Split/Shared Substantive Portion

Suggested Attendees:

Healthcare CEOs, CFOs and COOs
Physicians and Non-Physicians Providers
Billing Staff and Companies
Healthcare Consultants
Hospital Director
Compliance Officers
Mid-Level Providers
Physicians
Coders
Billers
Clinic Managers
Nurses
Practice Manager
Office Managers
Reimbursement Managers and Staff
ASC Directors
Health IT Software Developers
Policymakers
Other Staff Involved in the Telehealth Services

About the Presenter:

Maya Turner, CPC, CPMA, CPCO, CFPC, CPC-I (AAPC Approved Instructor), has nearly 30 years of experience in revenue cycle management, coding compliance and education. Maya’s dynamic teaching style and unparalleled expertise will undoubtedly enrich the learning experience for our participants, ensuring a comprehensive and engaging educational journey. A seasoned certified coder and auditor, boasting of nearly 30 years of experience and subject matter expert to many coding compliance subjects, she especially is sought after for her in depth knowledge base of pro fee multi-specialty practice, primary care, hospitalists, telehealth, inpatient, as well as SNF. She is also a published author having written articles for AAPC and HCCA, and currently is a part of the ACDIS Leadership Council. She’s scheduled to speak at such venues as HealthCon, and HCCA’s Compliance Institute.

She showcases her unmatched three-dimensional thinking in complex subject matters, Maya's success is marked by her clear and well received presentation style, reflecting her profound understanding and expertise. Maya also has a consulting service called Turner Expert Consulting Services, LLC. This venue allows her to assist other entities and provide training and expertise outside of her current employer. It’s with this, bringing her great joy to assist others in any way she can.

Additional Information:

System Requirement:

Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to hear clearly

For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

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