Can an initial hospital visit be split/shared?
Hospital evaluation and management visits are reported according the level of work done per day. Therefore, only one visit would be reported per date of service by any given provider, but the level of visit billed may actually be comprised of the work done by a nonphysician practitioner and a physician from the same group practice done on separate encounters the same date of service. Typically, this is seen in the performance of a subsequent hospital visit billed and paid under the physician rate of reimbursement which is acceptable provided these encounters were: • medically necessary (i.e. the physician’s portion of the work done was from an actual medically necessary face to face encounter with the patient) • performed separately and • were documented separately. In the performance of an initial hospital visit, if the patient is an established patient in the group practice, we would allow this visit if split/shared; but if the patient is new to the group practice, the expectation wo
