2024 AANS Neurosurgical Topics for APPs - On-Demand-Reimbursement Basics for the Neurosurgical APP

Video Transcription

Video Summary

Michael Johnson provides a comprehensive overview of reimbursement processes specific to Neurosurgical Advanced Practice Providers (APPs). He emphasizes that APPs, including PAs and NPs within neurosurgery, play a crucial role with Medicare covering their services at a uniform rate of 85% of the physician fee schedule. Johnson dispels myths, clarifying that Medicare does not prohibit APPs from handling new Medicare patients or require a physician's presence for each interaction.<br /><br />He explains the CPT codes crucial for billing, detailing how each code's value is determined by work, practice expense, and malpractice components. Johnson delves into billing conventions like "incident to" and "split shared," explaining compliance and the potential for billing fraud. He highlights that while APP contributions before and after surgery might not be directly reflected in RVUs, they hold significant financial value.<br /><br />Regarding surgical procedures, he explains the global surgery package, differentiating between zero, 10, and 90-day global periods. Johnson also covers the role of APPs as assistants at surgery, emphasizing correct documentation and awareness of Medicare’s guidelines, especially in teaching hospitals. He concludes by urging APPs to stay informed on reimbursement regulations to maximize their value and avoid compliance pitfalls.

Keywords

Neurosurgical APPs

reimbursement processes

Medicare coverage

CPT codes

billing conventions

global surgery package

RVUs

surgical assistants

compliance regulations