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Medical coding resources for physicians and their staff. CodingIntel was founded by consultant and coding expert Betsy Nicoletti.

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Incident To Services – Medicare

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
  • Brief video overview
  • Billing and coding rules
  • Enrollment of non-physician practitioners (NPPs) for incident-to billing
  • Incident-to and change to medications

Definition of Incident-to services

Incident-to services are services provided in a non-facility setting to Medicare patients that are incident-to a physician’s or non-physician practitioner’s (NPP) treatment and plan of care.  Use these in place of service 11. There are other non-facility settings in which incident to services may be provided, but office is the most typical.

Explanation

Incident-to care is care provided incident-to the care provided by the physician. This means, that the patient must be seen by the physician at a prior visit, the physician develops the plan of care, and that the care provided is an integral part of the physician’s treatment plan. The physician must stay actively involved in the plan of care and be in the office when the service is provided.


Coming in May

Medicare incident to and shared services webinar

Registration for this 60 minute webinar will open in April.
Keep an eye out here for details.

 

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Last revised May 5, 2022 - Betsy Nicoletti
Tags: medicare incident-to and shared services, primary care_other E/M services

Wondering about the rules for HCC coding?

Wondering what the rules are for HCC coding, and where you can find them? This video answers your questions. The topic is important to medical practices because risk-adjusted diagnosis coding is part of Medicare Advantage contracts, many commercial contracts and Accountable Care Organizations (ACOs). Sign up for our monthly newsletter to download the whitepaper and watch the video.

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Our mission is to provide accurate, comprehensive, up-to-date coding information, allowing medical practices to increase revenue, decrease coding denials and reduce compliance risk. That's what coding knowledge can do.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions. For more about Betsy visit www.betsynicoletti.com.

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