Medicare has specific rules for billing for nurse practitioners and physician assistants and other office staff incident to a physician services in an office.  This article includes:

• Description, explanation and codes for incident-to services
• Billing and coding rules
• Brief video overview
• Enrollment of non-physician practitioners (NPPs) for incident-to billing

See our Medicare Incident-to and Shared Services Guide for additional information.

What are incident-to services?

• Services billed to Medicare using the physician’s National Provider Identifier (NPI) but performed by licensed NPPs or auxiliary staff
• Services billed to Medicare performed by auxiliary staff using the NPP’s NPI number.

According to CMS,

Incident to a physician’s professional service means that the services or supplies are furnished as an integral, though incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury of illness.