Author Topic: Codes to use with Nurse Practitioners  (Read 1836 times)


  • Newbie
  • *
  • Posts: 1
Codes to use with Nurse Practitioners
« on: May 27, 2010, 09:40:18 PM »
I need help with this one. I am wondering if anyone can help me.

We just hired a nurse practitioner at our office but found out that some insurances will not pay under the nurse practitioner. Is there a modifier that I can use? Normally we use codes 99204 and 99214 for the office visit.


  • Full Member
  • ***
  • Posts: 130
    • Professional Medical Billers Association
Re: Codes to use with Nurse Practitioners
« Reply #1 on: May 27, 2010, 10:41:53 PM »
Saw this on the aapc site:

Modifier SA is for a nurse practitioner rendering service in collaboration with a physician.
Some carriers will recognize these modifiers and some will not. Those that will not may deny the claims because the modifier is not one they recognize and that makes the claim not a "clean claim".

I would query your biggest carriers first, and/or those you have ties with, and ask them if they recognize the SA modifier (it doesn't seem the YR applies to this). If so, how do they want modifier SA utilized?
Michelle Rimmer, CHI, CPMB
President-Professional Medical Billers Association
Owner-ABA Therapy Billing Services
Author, 'Medical Billing 101' and 'Coding Basics: Understanding Medical Collections


  • Full Member
  • ***
  • Posts: 227
Re: Codes to use with Nurse Practitioners
« Reply #2 on: June 09, 2010, 04:27:14 PM »
I would also look at 99211 as this code is most used by NP's as this does not require the presence of a physician and is most commanly used by NP's
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare