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09/01/2021

Shared Visit Billing: New Rules Proposed by CMS

The Centers for Medicare & Medicaid Services (CMS) proposes changes to rules on billing shared/split visits.

What Are Shared Visits?

Nurse practitioners (NPs) or physician assistants/physician associates (PAs) and physicians sometimes "share" patient visits. A shared visit (also called a "split visit") is one where both types of clinicians participate in evaluating and managing a patient on a given day. CMS defined shared visits in the 1980s and issued rules on how to bill shared visits. At that time and ever since, CMS has held that their rules on billing shared visits have applied only to hospital inpatient visits, hospital outpatient visits, and emergency department visits. (A different set of rules applies to shared office visits, the billing for which is known as "incident-to" billing.)  

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