What billing condition applies when a patient is seen by a nurse practitioner (NPP) as part of a physician's treatment plan?

When a patient is seen by a nurse practitioner (NPP) as part of a physician's treatment plan, the service is typically billed under the physician's National Provider Identifier (NPI) and paid at 100%. This is because in many healthcare settings, the NPP works under the supervision of a physician and provides care as part of a collaborative team approach.

Billing under the physician's NPI allows for seamless integration into the physician's practice, ensuring that patient care is delivered in a coordinated manner. This billing practice provides the advantage of full reimbursement, which aligns with the roles that NPPs play in delivering care within a physician-led framework.

Furthermore, this arrangement reflects the regulatory and reimbursement policies that often require services provided by NPPs under the aegis of a physician to be billed as if they were rendered by the physician, thus ensuring adequate compensation for both the physician and the NPP's contributions to patient care.