Compliant Use of the Nurse Practitioners (NPs) and Physician Assistants (PAs) in 2022 – Post Test

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Question 1 of 10

1. Question
1. As of 01/2022, “Incident to” visits can be performed in each of the sites of service below (select ALL that are correct):
- a. A physician’s office that is not provider-based
- b. An outpatient department of a hospital
- c. An inpatient admission to the hospital
- d. On the initial visit of a patient being admitted to a skilled nursing center for rehab
Question 2 of 10

2. Question
2. A Local Carrier Determination (LCD) is made by
- a. A Medicare Administrative Contractor (MAC)
- b. CMS
- c. Blue Cross Blue Shield for their national contract coverage
- d. A local hospital when it decides to not sign a contract with a Medicare Advantage Plan
Question 3 of 10

3. Question
3. The standards of clinical care set forth by CMS
- a. Are higher for physicians than NPPs
- b. Are a different scope for physicians than NPPs
- c. Were cancelled during the pandemic and will be re-instituted after the PHE
- d. Are the same for physicians and NPPs
Question 4 of 10

4. Question
4. The reimbursement that a Physician Assistant gets from a Medicare patient is
- a. The same as an NP and is 85% of the Medicare Physician Fee rate
- b. The same as a physician only with subsequent Nursing Center patients
- c. Less than an NP
- d. 90% of the physician rate
Question 5 of 10

5. Question
5. The billing of split/shared services in 2022 can be determined by (select all that apply)
- a. The provider who spends >50% of the time in care delivery in a calendar day
- b. The physician’s total time in care delivery over a 3-day period
- c. The provider who documents and performs the substantive part of the key component that drives the bill for the encounter
- d. The physician’s documentation based on the AMA 1992 E&M office guidelines
Question 6 of 10

6. Question
6. The modifier to be attached to the CPT code to designate this as a split/shared visit is
- a. SV
- b. SSV
- c. FS
- d. FTT
Question 7 of 10

7. Question
7. “Incident to” true statements (select ALL that are TRUE)
- a. Is able to be delivered by both PAs and NPs the same
- b. Allows 100% physician fee reimbursement if all rules for this are followed
- c. Is illegal in some states
- d. Is for care delivered by NPPs in follow-up to pre-set treatment plans of care
Question 8 of 10

8. Question
8. Direct supervision of a NPP is defined as being
- a. In the same town, readily available by phone
- b. In the same building, readily available
- c. In the same floor of the building, readily available
- d. In the same suite, down the hall, readily available
Question 9 of 10

9. Question
9. Incident to billing is NOT allowed with (select all that are true)
- a. Established patients with Medicare in follow-up of chronic conditions
- b. New patients with Medicare
- c. Established patients with new problems that have not been seen by the supervising physician
- d. Established patients in the ED that the NPP is seeing alone who need new diagnostic tests
Question 10 of 10

10. Question
10. The following visits CAN be shared with a physician in 2022 (select all that are true):
- a. Hospital Inpatient Admissions (day one)
- b. Hospital inpatient day two rounding encounters
- c. Procedures
- d. Critical Care

Compliant Use of the Nurse Practitioners (NPs) and Physician Assistants (PAs) in 2022 – Post Test

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