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Billing and Financial

In Reply To: palliative care inpt billing
Next Reply: Re:Re:palliative care inpt billing RE Nurse practitio
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Post Re:palliative care inpt billing RE Nurse practitio
Author: EKF
Date: Oct 8, 2007 10:50 am
Diane, Please comment if you have the time:

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?
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Re:Re:palliative care inpt billing RE Nurse practitio (by SHELIAHAMBY on 05/08/2008)
Was there ever any response to this question? I am also trying to set up billing for Palliative care services for in house patients by a NP employed by hospital. Any help is greatly appreciated.
Re:Re:palliative care inpt billing RE Nurse practitio (by ShredaNP on 05/08/2008)
If I might offer a response... 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.
+ Re:Re:palliative care inpt billing RE Nurse practitio (by kkerr on 05/08/2008)
Hello, 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

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