Have some extra cash you’d like to send to the government?

No it isn’t tax time. But failing to follow Medicare rules when submitting claims could result in a paycheck for Uncle Sam. In fact, you could have to return money that you’ve already collected from the government. I know three practices that have done that this year, and all for the same reason. What was the reason? Billing for student services. What kind of students? Nurse practitioner and physician assistant students. Students are not licensed and enrolled in Medicare or in any other third-party insurance company and you may not bill for their services.

 Some groups think that if the supervising mid-level provider countersigns the note, or indicates that they saw the patient as well and agreed with the student’s assessment and plan, that they can bill a service under the supervisor’s provider number. Nothing could be farther from the truth. Student services are never billable. It doesn’t matter if the student is a medical student, a PA or NP student, or a physical therapy student or the smartest, brightest, most promising student in the world. You cannot bill for their services.

 But groups want to have students involved in the care of their patients. As a service, they like to take a PA student or an NP student to give those students practice experience. If they do this, only the service provided and documented by the licensed mid-level provider may be reported. A student may document what a staff member may document, which is the review of systems and the past medical, family and social history as long as there’s evidence that the billing provider reviewed this. Most practices want the student to have a fuller experience. I agree with this. Allow the student to see the patient and document the service. However, the supervising clinician must see the patient, examine the patient and document the work performed. When submitting a claim for this service, base the claim only on the work done by the licensed professional and the note documented by that professional.

 Student services are never billable. Unless you want unless you want to send money back to Uncle Sam, don’t make this mistake.

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