An NPP in the ED is defined by Medicare as either a nurse practitioner (NP) or a physician assistant (PA). The DEA uses the term “midlevel’s” (MLP). Some federal agencies refer to them as advance practice provider (APP’s).
When an emergency department E/M is shared between a physician and an MLP, the service may be billed under either the physician’s or the MLP’s NPI number.
If there is no “face-to-face” portion of the E/M encounter between the patient and the physician, the service may only be billed under the MLP’s NPI number and payment will be made at 85% of the allowable.