Advanced Practice Provider: Coding Rules for Medicare

This comprehensive module provides healthcare billing professionals, practice managers, and clinical staff with essential knowledge about Medicare billing requirements for Physician Assistants (PAs), Nurse Practitioners (NPs), and Clinical Nurse Specialists (CNS). The course addresses the three primary billing methodologies recognized by the Centers for Medicare & Medicaid Services (CMS): Incident-to billing, Direct billing, and Split/Shared billing. Participants will learn to distinguish between CMS and American Medical Association (AMA) CPT guidelines, understand place-of-service restrictions, and apply appropriate billing methods based on clinical scenarios. The module emphasizes compliance with Medicare regulations, state scope-of-practice requirements, and proper use of modifiers, particularly the FS modifier for split/shared visits.

Learning Objectives:

Upon successful completion of this module, participants will be able to:

1. Define and Differentiate APP Billing Methodologies

2. Apply Incident-to Billing Requirements

3. Implement Direct Billing Protocols

4. Execute Split/Shared Billing Correctly

5. Select Appropriate Billing Method Based on Clinical Scenarios

Target Audience 

• Medical billers and coders 

• Practice administrators and managers 

• Physician Assistants and Nurse Practitioners

• Clinical Nurse Specialists

• Compliance officers

• Healthcare administrators

• Revenue cycle management staff

Join Christine Banks and earn one CEU with our live one-hour Webinar!

Start time: 12:00 pm CST on August 19, 2026