wjhpctspa Posted July 4, 2015 Share Posted July 4, 2015 Do any PAs work in SNFs (skilled nursing facilities) doing consults for any service( not working for the attending of record) and bill 99304, 99305, 99306? I'm being told these codes for initial care can only be billed by a physician and I am only allowed to see follow up patients, any thoughts? Link to comment Share on other sites More sharing options...
Sam I Am Posted July 5, 2015 Share Posted July 5, 2015 I have lots and lots of thoughts on SNF/LTC, supervising physicians, Medicare fraud, and PA-C burn out. As for your specific question, I'm not sure as I've been an employee and not an independent contractor. From my experience (and it's a very murky one), I always did all the Initial and Follow up visits. That's where the murk factor comes in - according to CMS, the Initial Visits has to be done by the MD. And now enters the State Department investigating the MD for fraud... Link to comment Share on other sites More sharing options...
Moderator ventana Posted July 6, 2015 Moderator Share Posted July 6, 2015 Do any PAs work in SNFs (skilled nursing facilities) doing consults for any service( not working for the attending of record) and bill 99304, 99305, 99306? I'm being told these codes for initial care can only be billed by a physician and I am only allowed to see follow up patients, any thoughts? I have lots and lots of thoughts on SNF/LTC, supervising physicians, Medicare fraud, and PA-C burn out. As for your specific question, I'm not sure as I've been an employee and not an independent contractor. From my experience (and it's a very murky one), I always did all the Initial and Follow up visits. That's where the murk factor comes in - according to CMS, the Initial Visits has to be done by the MD. And now enters the State Department investigating the MD for fraud... as I hear this a fair amount Admission Visit - not the first visit - but the visit that gets coded as the admission H+P MUST be done by MD/DO to a SNF - slightly different rules for LTC non SNF but likely still applies If you are doing every H&P and the doc is not seeing them then you are not in compliance, well actually the doc and the facility is not in compliance.... Make sure you are not enabling them to do this But if you are not billing for an admission H&P and they are they might not come after you The regs are pretty clear that the doc has to be involved, if they are not they are putting themselves at risk. Defensive charting and talking to the doc and appropriate charting can protect you some, but if it is truly a different situation, well then you best get out.... Link to comment Share on other sites More sharing options...
LIPPER Posted September 13, 2015 Share Posted September 13, 2015 / Sent from my iPhone using Tapatalk Link to comment Share on other sites More sharing options...
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