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
Speaker
Pam D. Apuzzo
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 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).