AAPC Certified Evaluation and Management Coder (CEMC) Practice Exam 2025 - Free CEMC Practice Questions and Study Guide

Question: 1 / 555

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

The service must be billed under the NPP's NPI.

The service is billed under the physician's NPI and paid at 100%.

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.

Get further explanation with Examzify DeepDiveBeta

The service is independently billed and compensated at 85%.

The service must be recorded as standby services.

Next Question

Report this question

Subscribe

Get the latest from Examzify

You can unsubscribe at any time. Read our privacy policy