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“Incident to” Services

Candice Fenildo, CHC, CPC, CPMA, CPB, CPC-1, CRHC, AAPC Fellow
Associate Consultant, Acevedo Consulting, Delray Beach, FL

Question: Three months ago, your physician diagnosed Mr Bones with rheumatoid arthritis, and gave him a regimen of medication and therapy. Today, your nurse practitioner is assessing this patient’s progress. Your provider is out of town attending a medical convention, but one of his partners is in the office. Is the visit with the nurse practitioner eligible for incident-to billing?

Answer: Yes. Medicare states that the physician who initiates the course of treatment does not need to be the same physician who oversees a staff member performing an incidental service, so the physician’s partner can do the supervising. Remember, however, that you must bill this work under the supervising physician’s Medicare number.

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