A visit in the hospital setting that is ”split” or “shared” by a physician or non-physician practitioner is subject to split/share billing guidelines. In 2024, CMS finalized their guidelines to split/shared billing to reflect changes enacted in the 2024 AMA CPT manual. In 2024, split/share service levels are determined by:
ASCO’s Coverage and Reimbursement resource on Split/Share E/M Services was updated to include more details on split/share billing, including updates, reporting criteria for time and medical decision making, and documentation requirements. Not all payers accept split/share billing. Please refer to individual payer policy for coverage.
New, revised and deleted J Codes for 4-2024