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2022/2023 Split/Shared Visit and Service Reference

Insight Article - June 2, 2022

Compliance Regulations

Staffing Models

Coding & Documentation

Recent changes to the Centers for Medicare & Medicaid Services (CMS) rules for split/shared encounters involving physicians and advanced practice providers (APPs) are an important area for healthcare leaders to understand, as they are sometimes confused with teaching physician or incident-to rules.

These rules, codified in CMS Regulation § 415.140, are set to be updated with implementation of a new final rule in 2023 following an initial rule update that was made effective in January 2022.

This member-exclusive split/shared visit and service reference details the 2022 and 2023 substantive portion definitions, as well as place of service and modifier usage, for E/M visits in outpatient facilities (excluding office visits in non-facility settings), hospital facilities, and skilled nursing facilities.

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About the Author

Veronica Bradley
Veronica Bradley CPC, CPMA
Senior Industry Advisor MGMA Englewood, CO

Veronica Bradley, CPC, CPMA, is a Senior Industry Advisor with MGMA and is CPC and CPMA certified. She has over 20 years’ experience in medical coding and auditing in various specialties. She is also well-versed hierarchical condition category and risk adjustment coding. Other areas of expertise include evaluation and management, procedural coding, Medicare reimbursement, and other critical factors in coding and auditing. Veronica has worked in private practice, group practices, academic school of medicine and hospitals. She focuses on educating based coding guidelines and code capture accuracy for all medical practice staff and believes coders must build rapport with healthcare providers to ensure healthy communication as necessary in the charge capture process.

Veronica received a bachelor’s degree from Regis University in Denver, Colorado in Health Information Management with a minor in Healthcare Administration. In her free time, Veronica appreciates spending time with her family enjoying the beautiful Colorado scenery.

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