Simplify your Medicare billing process with our Split Shared Billing , ensuring accurate and efficient reimbursement for healthcare services.

1. 2023 And Beyond: The Evolution Of Split Shared Billing In
Medicare
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2. Physician assistants (PAs) and nurse practitioners (NPs), collectively known as advanced practice providers
(APPs), play a vital role in healthcare across various specialties. Their responsibilities, including billing for
clinical and procedural services, have evolved significantly. In particular, the Centers for Medicare and
Medicaid Services (CMS) has implemented substantial changes to split/shared billing policies, impacting
APPs and physicians treating patients collaboratively. To understand these changes, tracing the historical
timeline that led to the evolution of split/shared billing services in the United States is essential.
Before 1997, CMS recognized NPs and PAs as facility support staff, reimbursed through the hospital’s cost
report without Part B billing. The Balanced Budget Act of 1997 marked a pivotal shift, allowing APPs to be
recognized as Part B providers. While advancing clinical practice, this change posed financial challenges as
APP salaries could no longer be included in the hospital’s cost report. To address this, CMS introduced the
practice of split/shared billing, enabling joint billing for Evaluation and Management (E/M) services by
physicians and APPs.
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2023 And Beyond: The Evolution Of Split
Shared Billing In Medicare

3. The split/shared practice allows E/M services jointly performed by a physician and APP to be billed at
100% of the Medicare Physician Fee Schedule (MPFS) under the physician’s name and National Provider
Identifier (NPI) number. Historically, these services were often billed under the physician’s name, with
minimal requirements on physician participation or documentation levels. However, as part of its annual
rulemaking process, CMS updated the split/shared guidelines in 2022, introducing significant
modifications.
● Attribution of Billing
● Critical Care and Skilled Nursing Facility Services
● Documentation and Billing Modifier
● Transition Period
● Transition to Time-Based Attribution
● Unclear Documentation Requirements
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The Split/Shared Practice

4. The evolution of split/shared billing in Medicare reflects a dynamic interplay between regulatory changes,
financial considerations, and the need for clarity in documentation and attribution. As CMS moves towards a
time-based model, healthcare providers face challenges adapting their billing practices and ensuring
compliance.
Outsourcing to 24/7 Medical Billing Services emerges as a strategic solution, offering expertise to navigate
the complexities of regulatory changes. Such a professional medical billing company specializes in staying
abreast of the latest guidelines, ensuring accurate billing, and mitigating the risk of non-compliance. By
entrusting billing processes to these professionals, healthcare providers can streamline operations, enhance
efficiency, and focus on delivering high-quality patient care. Outsourcing becomes a valuable ally in
maintaining financial stability, fostering adaptability to evolving regulations, and ultimately contributing to
sustained growth in the healthcare industry.
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Final Thoughts : The evolution of split/shared billing

5. About us
We are a medical billing company that offers ‘24/7 Medical Billing Services’ and support physicians,
hospitals, medical institutions and group practices with our end to end medical billing solutions. We help
you earn more revenue with our quick and affordable services. Our customized Revenue Cycle
Management (RCM) solutions allow physicians to attract additional revenue and reduce administrative
burden or losses.
Media Contact:
24/7 Medical Billing Services
28405 Osborn Road, Cleveland, OH 44140
Phone no / Fax : +1 888-502-0537
Email us: info@247medicalbillingservices.com
https://www.247medicalbillingservices.com/