CMS Updates Policy on Hospital Shared Visits
The Centers for Medicare and Medicaid Services (CMS) issued Transmittal #788 dated December 20, 2005, which states that a consultation may not be billed as a shared visit. Office and hospital evaluation and management services continue to be eligible for shared visit billing. A shared visit is when both a physician and a PA treat the same patient on the same day in the hospital/office setting. Medicare allows the work of both health care professional to be combined with the service billed at 100% under the supervising physician as long as the physician performs some face-to-face portion of the visit. The physician’s involvement must be documented on the patient’s chart. Be aware that under Medicare’s guidelines, shared visits in the office setting must first meet the “incident to” requirement, making the concept of an office-based shared visit nearly a moot point.
AAPA held discussions with CMS and had argued that consults should be included as eligible shared visit services. The CMS transmittal can be found at: www.cms.hhs.gov/transmittals/downloads/R788CP.pdf.
Printed with permission, Michael Powe, AAPA Reimbursement Watch.
Questions can be referred to Ron Mezick rbmezick@aol.com.