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Administration
One-Hour Concurrent Session

Pro/Con: Split-Shared Billing in the ICU: Should We Bill Solely Under the APP?

Monday, February 24, 2025
11:00am – 12:00pm Eastern Time
Location: W224GH
CE: 1

Recent changes allowing split-shared billing for critical care services have forced many institutions to rethink their workflows, staffing, and work relative value unit (wRVU) attributions. In this pro/con debate, a neurointensivist who is a certified professional biller (CPB) will argue that split-shared billing allows for the greatest ability to harvest revenue and therefore is the best approach and that institutions should rethink who gets the credit and how they incentivize clinicians. An advanced practice provider (APP) system leader will argue that institutions should continue to bill solely under the physician to avoid the 15% revenue loss associated with APP billing. Two speakers with experience in critical care APP leadership and education in DNP programs will discuss how institutions should communicate their decisions to their APP teams to build cohesiveness.

Learning Objectives:

  • Define split-shared billing in critical care
  • Describe the financial ramifications of billing solely under either the physician or the advanced practice provider (APP)
  • Describe the workflow ramifications of changing from a traditional physician-based billing model to a time-attribution-based billing model
  • Illustrate the repercussions of both models on physician and APP compensation
  • Discuss hybrid billing models and the associated positives and negatives

Presentations:

  • 11:05am – 11:25am Eastern Time
    Pro: Split-Shared Billing Allows the Greatest Total Revenue Collection: We Shouldn't Care Which Team Member Gets the Credit

    Ryan Hakimi, DO, MS, FCCM – University of South Carolina School of Medicine-Greenville

  • 11:25am – 11:45am Eastern Time
    Con: Institutions Should Opt out of Split-Shared Billing to Avoid the 15% Revenue Loss When the APP Bills: Only Physicians Should Bill

    Christopher Newman, MBA, PA-C, FCCM – University of Colorado School of Medicine