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Featured Practice Question

The physicians I work with are often out of the office but available by phone or text. They want me to start covering during cardiac stress tests but are unclear of the "rules". Does a physician need to physically be in the building when I am doing stress tests? Does a physician need to be in the office in order for me to bill incident-to? My practice setting is cardiology and I have practice protocols. The doctors would like something in writing to clear up any questions that might arise should we choose to merge with another organization.

The level of supervision is established by your individual organization (e.g. by-laws, protocols, etc.) and typically indicated within your Standardized Procedure. There are no set "rules" for supervision. Regarding incident-to billing, the requirements/rules are very specific, and, yes, the physician needs to be in the office. I would recommend that you and/or the physicians work with the organization's billing and/or compliance team to ensure the incident-to requirements are in place, as they are very specific.

Featured Legal Question

As an NP in Internal Medicine, I am frequently asked to refill controlled medications, either electronically or hard copy, for an MD who is not available at that time or is off for the day. Is this legal if I have never seen the patient or not recently seen the patient?

You need to have something in your protocols and make sure it is a one-time event. There is no law that requires this, but it is a recommended “best practices” approach.

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