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 explains them.
Definition of Incident-to services
Incident-to services are services provided in a physician office 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.
Incident-to care is care provided in the physician’s office or patient home incident-to the care provided by the physician. This means, that the patient must first 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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