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CPT codes, descriptors and other data only are copyright 1999
American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS apply.
Non-Physician Practitioner
1. The physician and nurse practitioner are employed by the skilled nursing facility. Sometimes, the nurse practitioner sees the patients on her own. She orders lab work, x-rays, etc., depending on the patient’s medical condition. Can these services be billed under the physician’s provider number? How is the original Plan of Care defined? (Last Reviewed: July 16, 2008)
1. The physician and nurse practitioner are employed by the skilled nursing facility. Sometimes, the nurse practitioner sees the patients on her own. She orders lab work, x-rays, etc., depending on the patient’s medical condition. Can these services be billed under the physician’s provider number? How is the original Plan of Care defined? (Last Reviewed: July 16, 2008)
You may bill incident to a physician’s service, if the physician is on the premises, the Plan of Care has been established, and there is a collaborating agreement between the physician and nurse practitioner. The original Plan of Care means that the physician establishes the treatment for the patient and the practitioner follows the physician’s orders. If the practitioner is changing the Plan of Care, then the service cannot be billed incident to a physician’s service. For more information regarding billing incident to a physician's service, please refer to the Pub. 100-04, Medicare Claims Processing Manual, Chapter 12, §30.6.13 and Pub. 100-02, Medicare Benefit Policy Manual, Chapter 15, §60.1 for an explanation of coverage for services rendered in a nursing facility.
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Non-Physician Practitioner