Split-shared visits are only allowed in the facility setting. CMS has extended the rule set in 2022 to 2023. Split-shared can be billed based on the documentation of the substantive portion for visit based on either time or Medical Decision Making (MDM). If based on time, combine the time between the APP and the physician to determine the code. The visit should then be billed under whoever spent more than half of the total time. If based on MDM the visit should be billed under whoever documented the entire MDM. If both providers documented their own MDM, the visit can be billed under the physician. CMS also states that if the physician documents their own MDM, it is not necessary for the patient to be seen by the physician. However, check with your hospital to see if they will allow this from a medical/legal perspective. As it stands, this option will be retired in 2024 and split-shared visits will only be allowed based on time.