Understand CMS Advanced Billing Practitioner Professional Billing
ICD-10 Monitor – January 2019
by Deborah Grider
Not billing the APP service can result in serious revenue cycle errors.
Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as Advanced Practitioner Professionals or APPs. I get questions all the time about APP billing, and during audits many times it is found that the rules just have not been followed. Usually, this is because they are just not understood. The other issue to keep in mind is that not all payors follow Medicare’s NPP billing guidelines. What guidelines do you follow for your APPs? It is important that every APP and physician research each contracted payor to understand and follow their particular guidelines.
Who qualifies as an APP?