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.

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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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