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Shared or Split Services – May 2022 Coding Tip

Shared or split services are Evaluation and Management (E/M) services performed jointly between a physician and a non-physician practitioner, in the same group, in a facility setting.

  • Split/shared facility services may be billed for encounters in any facility setting, including the emergency department and skilled nursing facilities
  • Services may include both face-to-face and non-face-to-face activities, as defined by CPT
  • The service may be billed for initial and subsequent encounters, for new and established patients and for critical care services (99291-99292)
  • Services billed using the physician’s National Provider Identifier are paid at a higher rate than those billed by a non-physician practitioner
  • The treating physician who performs the ‘substantive portion’ of the visit and bills for it must sign and date the encounter
  • Prolonged services are allowed for codes that have a typical time in the descriptor
  • The services must be reported with a new modifier FS (Split or (Shared) Evaluation and Management Visit) 1

E/M services may be billed as shared or split services when provided in a facility setting. Prior to 2022, they could be provided in an office setting if they also met the requirements for incident-to-billing. CMS is no longer allowing shared services in an office setting, although incident-to-services are still allowed. 2

  1. PartBNews; November 15,2021/Volume 35, Issue 44
  2. CMS 2022 Physician Fee Schedule Final Rule, page 426