2025 Billing & Documentation Essentials for NPs and PAs: Stay Ahead of Regulatory Changes

As the new year approaches, Non-Physician Practitioners (NPPs), including Physician Assistants (PAs) and Nurse Practitioners (NPs), should review any upcoming changes to insurance policies and regulations affecting their practices. While CMS/Medicare publishes its policies in manuals available on its website, other insurers may have unique guidelines or variations from CMS/Medicare rules that require attention. Billing practices for NPP services can also differ significantly from those outlined by CMS/Medicare, so reviewing each insurer's specific policies ensures compliance and avoids denied claims.

It is essential for all parties involved to fully understand each billing method and how specific guidelines impact the utilization, documentation, and billing of NPP services. Clear knowledge of these guidelines helps practices accurately manage and optimize billing processes for NPP services.

CPT guidelines, combined with substantial CMS/Medicare changes for split/shared visits, have brought notable shifts in practice workflows. If your practice has not yet adjusted to these changes, you may risk improper documentation and inaccurate billing for services. Implementing these updates is crucial to ensure compliance and correct billing practices.

The session will also cover AMA-identified changes for 2025, providing you with the latest updates. This timely event will equip your practice with the knowledge to maintain compliant documentation, coding, and billing for NPP services

Webinar Objectives

• Changes for 2025 from the AMA
• Changes for 2024 for Split Shared visits - who has to do what portion of the service and what documentation is needed – in which location
• Scope of Practice – understanding differences state to state
• Incident To – documentation and billing of this often mis-understood concept
• Direct Billing – the simplest and more direct method of documentation and billing

Webinar Highlights

• What changes for NP’s and PA’s did the AMA announce for 2025
• What are the Split Shared guidelines from CPT for 2024?
• What are CMS/Medicare’s guidelines for Split Shared visits in 2024?
• What are the documentation requirements of the supervising physician for incident to services
• What documentation does the NP/PA need to include in the patient’s record when billing incident to services
• What locations can NP’s and PA’s utilize for split or shared visits or incident to visits
• What role can NP’s and PA’s have in surgery and with procedures
• Updated information on use of Audio/Video supervision for 2025 AND 2026
• CMS has listed situations where direct supervision has been permanently defined allowing use of audio/video real time communications
• CMS has extended temporarily the definition of "direct supervision" for certain situations but only through 2025
• Clarification on supervision of residents by Non-physician practitioners
• What comments were made at AMA 2025 RBRVS symposium regard prescription drug management?

Who Should Attend

Coders, Billers, Auditors, Office Managers, Office Administrators, Nurse Practitioners, Physicians