Unraveling the Teaching Physician (PATH) Guidelines

Why Should You Attend:

CMS (Centers for Medicare and Medicaid Services) has issued what are referred to Physician at Teaching Hospital (PATH) guidelines. This allows the physician to use a resident’s or fellow’s note for the purpose of billing when other documentation requirements are met. Teaching hospitals and healthcare entities benefitting from the CMS Teaching Physician provision for residency programs have found it challenging to balance providing quality resident education while understanding and adhering to the CMS guidelines which dictate the circumstances under which a physician could be reimbursed while working along with residents and medical students.

In January 2018, CMS has revised a portion of these guidelines, to the delight of many physicians. However, Teaching Physician activities are still monitored closely by federal audit programs. It is, therefore, important that physicians and medical coders understand these guidelines and correctly identify billable services when billing under this provision.

This webinar is designed to explain services that are billable under the PATH guidelines and unravel the documentation requirements for various types of services such as office visits, inpatient rounds, as well as psych and critical care services. We will also discuss who qualifies when billing under the Primary Exception rule and correct use of modifiers when billing for these services.

Areas Covered in the Webinar:

• Identify and define provider types affected under the PATH guidelines
• Determine appropriate documentation needed when billing under the PATH guidelines.
• Discuss billing under the Primary Care Exception
• Identify appropriate modifiers required when billing Medicare

Who Will Benefit:

• Medical Billers
• Medical Coders
• Office Managers
• Coding Compliance Officers & Auditors
• Physicians working in Academic Medical Centers (Teaching Hospitals)

LaTrece Freeman Baker
Owner, Physicians Choice of Certified Coders

LaTrece Freeman-Baker, CPC, CPCO, CPMA, CPC-I, is the owner and Program Director of Physicians Choice of Certified Coders [PCOCC] Medical Billing and Coding service. As such, she oversees the billing, coding and compliance functions for physician services. LaTrece has had an extensive career managing the business side of medicine, spending over 20 years becoming an expert in medical coding and billing within many ambulatory settings, including physician practices, ambulatory surgery centers and FQHCs. More recently, she served as the Director of Physician Revenue Cycle and Provider Education at two of Chicago's major healthcare systems.

Over the years, LaTrece has successfully developed, implemented and taught curriculum surrounding medical coding and billing conventions to physicians and coders alike, in an effort to ensure optimal reimbursement for physician services while keeping a watchful eye on compliance regulations from both governmental and private payers. Due to the increased focus on coding and compliance in healthcare, LaTrece has been certified in three key coding areas: Physician Coding (CPC), Healthcare Compliance (CPCO), and Professional Medical Auditing (CPMA). These certifications, obtained from the American Academy of Professional Coders (AAPC), have enabled LaTrece to expand her expertise of Medical Coding and Compliance in order to better assist healthcare providers in understanding and managing this business side of medicine.

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