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Q&A: How to bill for an NP's services

Article

A solo practitioner must apply for a Type II NPI, which will become the group NPI if the practitioner wants to bill for both his own services and those of a staff nurse practitioner.

I am a solo practitioner who employs a nurse practitioner who is a W-2 employee. I would like to set up a separate office and have her staff it several days a week and bill for her services. Currently, I am using my individual National Provider Identifier to bill, and the services she provides are incident to my services. In order to credential her independently, will I have to incorporate in order to get a group NPI number, so that payment for her services will come to me?

While this is an accounting-related question as much as one of billing, perhaps we can shed some light on the process. If an individual NPI is obtained for your NP using her Social Security number, payment for her services will be directed to her. Since you already submit withholding for her W-2 wages, you probably already have a tax ID number set up for that purpose, even though you are a solo practitioner. You need to check with your accounting firm (one familiar with medical practices) to find out. If that is so, use the existing number to apply for a Type II NPI, which will then become your group NPI. If the group NPI is used to bill both of your services, all payments will come to you. This will not be an uncomplicated process and will involve recredentialing your independent number to the new Type II NPI. Enlist the aid of a reputable practice management consulting firm if you need to. The investment will pay for itself many times over.

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health