Views
CAPC Palliative Care Discussion Forum
Billing and Finance
palliative care inpt billingAuthor: Baya
Date: Jun 21, 2007 4:44 pm
IMPORTANT: In order to post a new message or reply to an existing post in the discussion you must login. If you are not a registered member you may join here.
The statements posted in the forum section of capc.org are opinions expressed by website visitors and do not necessarily represent the viewpoints or positions of the Center to Advance Palliative Care(CAPC). CAPC is not responsible for the factual or legal accuracy of any of the statements posted.
General questions about using the CAPCconnect™ palliative care discussion forum?
Email: Jennifer.Raiten@mssm.edu
Lost login username/password questions? Email: Margaret.Schutz@mssm.edu
http://www.capc.org/support-from-capc/capc_presentations/
The links above have detailed information on physician and nurse practitioner billing. Let us know if these do not answer your questions.
Diane Meier
Diane E. Meier, MD, FACP
Director, Center to Advance Palliative Care
Professor, Geriatrics and Internal Medicine
Director, Hertzberg Palliative Care Institute
Mount Sinai School of Medicine
New York, NY
I am looking for information on LTC billing as well.
Mindy
In the AAHPM Quick Reference Guide For Physician Coding, Billing, and Reimbursement for Hospice and Palliative Medicine Services, the last line of pg 22 says,
"Employed NP in the hospital or NF: If the NP is employed by the hospital or SNF/NF, the services he/she provides are covered and reimbursed in the DRG or PPS amount and no additional billing is allowed." It was my understanding that as NPs we could bill even if we were employed by the hospital, is this incorrect?
My understanding is that if you are employed by the facility, much depends on the cost center that you are affiliated with. If you are associated with nursing, that is affiliated with the reimbursement in the DRG. If you are part of the medical staff, then you are not.
That is my understanding and if anyone else can elaborate, that would be appreciated. I know that this issue is one that is commonly addressed in many CAPC presentations and is most likely addressed somewhere on the website, if you look for it.
Great question. You are correct, the rule was changed in April 2007, and now NPs, whether or not they are employed by a medical group or the hosptial, can bill for their services, assuming appropritae protocols etc are in place.
This informational bulletin from CMS explains the change, and includes a link that you can use if you would like to clarify the policy with your Medicare carrier.
http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM5221.pdf
Best,
Kathleen Kerr
Senior Analyst
University of California San Francisco
Palliative Care Leadership Center