BC Advantage - 2010 Issue 1
Are changes to physician incident-to services on the horizon?
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Article Overview
This article examines a federal review of Medicare physician incident-to services, including findings from an OIG study, CMS’s response to recommendations, and the policy implications for how these services are supervised and reported. It is relevant to physicians, coders, compliance staff, and revenue cycle professionals who need to understand potential changes to Medicare guidance and oversight.
Why This Topic Matters
Incident-to billing affects how physician services performed by staff are reported and scrutinized under Medicare. Changes in this area can influence compliance processes, supervision practices, and documentation standards for organizations that bill under Medicare Part B.
Article Sections
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OIG study findings on Medicare physician services
Summarizes the federal review that examined physician services billed during the study period and identified concerns about nonphysician performance of certain services.
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CMS guidance on incident-to services
Reviews Medicare manual guidance describing the general framework for services billed under incident-to provisions and the roles involved.
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OIG recommendations and CMS response
Outlines the policy recommendations made after the study and the agency response to those recommendations.
What You Will Learn
- The scope of an OIG review of Medicare physician incident-to services
- How CMS guidance frames incident-to billing in general terms
- What kinds of policy changes were recommended after the study
- How CMS responded to proposed reporting and oversight changes
Who Should Read This
- Physicians
- Medical coders
- Compliance officers
- Billing staff
- Revenue cycle professionals
- Healthcare administrators
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