What is the proper billing process when a physician is unavailable for supervision?

The correct approach when a physician is unavailable for supervision is to bill the services as provided by the non-physician practitioner (NPP). This reflects the necessity to comply with Medicare billing guidelines, which stipulate that for services provided by NPPs, the supervision of a physician is typically required. However, in the absence of a supervising physician, the services offered by NPPs, such as nurse practitioners or physician assistants, can still be billed under their provider numbers.

For billing to proceed accurately under these circumstances, it’s essential that NPPs are allowed to practice within their scope of service and that the documentation clearly supports the services rendered. This ensures compliance with coding and billing regulations, ultimately protecting reimbursement and reducing the risk of claim denials.

The other billing scenarios listed do not hold under CMS guidelines. While incident-to billing allows for certain services to be billed under a physician's National Provider Identifier, it requires that the physician provide direct supervision during the encounter, which isn't possible in this situation. Denying a claim outright wouldn't be appropriate if services were rendered legally and appropriately by an NPP. Lastly, requiring all billing to occur through the physician in the office would contradict established guidelines regarding the autonomy and capacity of NPPs to provide and