This webinar is designed to help healthcare providers and administrators navigate the complexities of CMS incident-to and split/ shared billing guidelines. These billing scenarios often cause confusion, leading to compliance risks and lost revenue. In this session, industry experts will break down the rules, clarify documentation requirements, and provide actionable strategies to ensure accurate billing and compliance. Whether you’re new to these concepts or seeking a refresher, this webinar will equip you with the tools to streamline your approach and optimize your practice.
Learning Objectives:-
- Understand the fundamental principles and differences between incident-to and split/ shared billing
- Identify key compliance requirements for documentation, supervision, and billing under both guidelines
- Analyze real-world scenarios to determine appropriate billing practices for incident-to and split/ shared services
- Implement practical strategies to avoid common pitfalls and mitigate compliance risks
- Optimize compliant reimbursement and operational efficiency while maintaining regulatory compliance
Areas Covered in the Session:-
- Incident-To Guidelines
- Scribe Requirements
- Utilizing Scribes
- Documentation of Scribes Services
- Key Incident-To Elements
- Site of Services
- Type of Personnel
- Type of Services
- Level of Physician Involvement
- Medicare Requirements
- Supervision
- Direct Supervision
- Physician Supervision
- CMS Split/Shared E/M Guidelines
- Emergency Department
- Initial and Subsequent Hospital
- Initial and Subsequent SNF
- Discharge Day Management
- Observation Care
- Critical Care
- Outpatient (Facility) Visits
- Prolonged Care
- Substantive Portion
- CPT E/M Office Revisions Level of Medical Decision Making (MDM)
- Time
- Sample Time Documentation Statements
- MD Attestation
- Split/Shared E/M Services and Procedures
- Physician Billing Scenario
- QHP Billing Scenario
- Critical Care Split/Shared Billing Scenarios
- CMS Billing Guidelines for Critical Care Services
- Critical Care Criteria
- Critical Care (99291-99292)
- Split/Shared E/M Modifiers – FS and FT
- Incident-To Physician
- MA Scribe
- QHP Scribe
- Split/Shared Critical Care
Who Should Attend?
- Physicians
- Physician Assistants
- Nurse Practitioners
- Certified Nurse Midwives
- Medical Coders
- Medical Billers
- Compliance Officers
- Hospital Administrators
- Practice Managers
- Revenue Cycle Staff
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Pam D’Apuzzo, CPC, ACS‑EM, ACS‑MS, CPMA, is a Managing Director at VMG Health leading the Coding, Compliance, and Operational Excellence Management service line. She is a recognized leader and industry expert in coding and compliance. Pam’s 30-plus years of healthcare consulting experience spans academic medical centers, community hospitals, faculty practice plans, and large private practices.
A trusted adviser to New York’s leading healthcare institutions, she conducts educational and training seminars and provides comprehensive compliance programs. Pam also has a successful record of practice management services including operational and billing review, practice assessment, practice start-up assistance, and EMR implementation.
Pam is a frequent speaker at conferences sponsored by the American Academy of Professional Coders (AAPC), Health Financial Management Association (HFMA), New England Healthcare Internal Auditors (NEHIA), California Health Information Society (CHIA), New York State Society of Physician Assistants (NYSSPA), Suffolk County Medical Society (SCMS), and American Association of Gynecologic Laparoscopists (AAGL).
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