Mastering Split/Shared Visits: Compliance, Documentation & Billing Accuracy

Are you confident your organization is billing split/shared visits correctly—or could you be at risk for compliance issues and audit exposure?

Split/shared visits have become an area of increased scrutiny, especially with evolving CMS guidance and clarification around the substantive portion requirement. This session is designed to break down the complexities of split/shared billing and provide clear, practical guidance for providers, coders, auditors, and compliance professionals.

Participants will gain a comprehensive understanding of when split/shared visits are appropriate, how to determine and document the substantive portion, and how to ensure services are billed under the correct provider. We will explore key differences between split/shared visits and other billing scenarios, including incident to services, and highlight common pitfalls that lead to denials, recoupments, and audit findings.

Through real-world scenarios and practical examples, this session will equip attendees with the tools needed to align documentation, coding, and billing practices with current CMS requirements.

Stay ahead of regulatory expectations, reduce compliance risk, and ensure your team is accurately capturing and reporting shared services.

• Define split/shared visits and explain when Medicare allows their use.
• Identify CMS requirements for split/shared billing, including applicable settings and provider roles.
• Understand and apply the substantive portion requirement based on current CMS guidance.
• Differentiate split/shared visits from incident to services and other billing scenarios.
• Recognize documentation requirements necessary to support compliant billing.
• Identify common compliance risks and audit triggers associated with split/shared visits.
• Apply correct billing practices, including provider selection and claim submission.
• Implement workflow and documentation strategies to support accurate and compliant shared visits.

• Definition and Overview of Split/Shared Visits
• CMS Guidelines and Regulatory Updates
• Substantive Portion Requirement Explained (Time vs. MDM)
• Eligible Providers and Appropriate Settings (Facility vs. Non-Facility)
• Documentation Requirements and Best Practices
• Billing Under the Correct Provider (Physician vs. NPP)
• Common Errors and Compliance Risks
• Differences Between Split/Shared and Incident To
• Audit Considerations and OIG Focus Areas
• Real-World Case Scenarios and Application
• Live Q&A Session

• Healthcare providers
• Medical Coders
• Billers
• Auditors
• Compliance Professionals
• Administrative staffs
• Hospitals and Health Systems
• Physician-based practices
• Legal and Regulatory Teams
• Physicians
• Physician Assistants
• Nurse Practitioners
• Certified Nurse Midwives
• Providers
• Medical Billers
• CDI Professionals
• Compliance Officers
• Revenue Cycle Professionals
• Revenue Cycle Staff
• Practice Managers
• Hospital Administrators

Keisha Wilson, the founder/CEO of KW Advanced Consulting, is a seasoned professional with over 20+ years of experience in the healthcare field. Her career in large teaching hospitals and acute ambulatory care systems includes roles such as an outpatient coding specialist, clinical documentation improvement (CDI) specialist, compliance operations coding and billing manager, interim compliance director, and consultant to various coding companies. Her extensive experience is a testament to her leadership and deep understanding of the industry.

An expert in Compliance and Revenue Cycle Management, Keisha specializes in risk-based audits, E/M auditing, multi-specialty coding, telehealth services, and Risk Adjustment/HCC education. She has developed and implemented comprehensive training programs for organizations of all sizes and is an approved instructor for KW Advanced Consulting, AAPC VILT, and NYC College of Technology.

Beyond her professional roles, Keisha serves on the Board of Directors for an outpatient mental health clinic and contributes to telehealth and compliance committees. She is also Chair of HDDH Working Group for the International Society for Telemedicine and eHealth (ISfTeH). She serves on the Advisory Board for The Nurses Pub and the HIM Department at South New Hampshire University (SNHU). A published author, she writes regularly for KW Advanced Consulting and collaborates with AAPC on coding articles and industry updates.