Five Facts about Split Visits

Got five minutes? You can learn five things about the crazy 2022 rules for Split Visits. Hopefully, this will end a lot of the confusion around these relatively new rules.

One

Split visits, as defined here, do not apply to splitting time with staff people (MAs, RNs, etc.). These rules apply only to physicians and Advanced Practice Professionals (APPs).

Two

For 2022, there are no new rules for APPs working "incident to" a physician in the office setting. There are no changes in 2022 for APP billing in place of Service 11.

Three

Also in 2022, in most settings, nurse practitioners and physician assistants can bill under their numbers. For most services (but not drugs), there will be an allowable reduction of 15%.

Four

Where this does apply is when a physician and an APP both see the patient in a hospital or other institutional settings. They must be in the same group. In 2022, who bills depends upon one of two criteria. The first criterion is time; that is, who spent greater than half the total time with the patient. The total time determination is defined similarly to the 2021 office-based coding requirements. Second, billing can depend upon which clinician does a complete component of E/M documentation (history, physical, or medical decision making). This will change in 2023 when the documentation guidelines for non-office visits change.

Five

Whoever bills for the service must sign and date the note. The visit must be appended with Modifier – FS.

Five Minute Fixes


Bobbi Buell, MBA
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