decisionhealth Newsletters, Answer Books - 2008 Issue 12 (December)
Answer_Book / Incident_to_Services / Incident
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Article Overview
This premium article discusses Medicare incident-to billing for new physicians and the limited circumstances in which it may be considered while enrollment is delayed. It is aimed at coders, billers, practice managers, and physicians who need a high-level understanding of supervision, practice-relationship, and facility-related requirements, along with a brief comparison to locum tenens billing.
Why This Topic Matters
Understanding the general framework helps practices evaluate whether a temporary billing approach may fit a new physician’s situation and avoid confusion between incident-to and other physician coverage arrangements.
Article Sections
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Incident-to for new doctors could ease cash flow delays
Introduces the billing scenario involving a newly hired physician whose enrollment is not yet complete. Summarizes the article’s focus on temporary Medicare billing considerations.
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Incident-to billing basics and CMS definition
Describes the general concept of incident-to billing and references CMS guidance on auxiliary personnel and physician supervision. Establishes the broad framework used throughout the article.
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Circumstances in which incident-to may be used
Outlines the limited situations discussed for using incident-to billing when a physician’s Medicare enrollment is pending. Covers the article’s high-level operational context without going into detailed selection rules.
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Rules and restrictions for incident-to billing
Summarizes the major supervision, practice relationship, and site-of-service limitations addressed in the article. Also notes the article’s discussion of liability and related Medicare considerations.
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Incident-to versus locum tenens
Compares incident-to with locum tenens at a general level and explains that the article distinguishes the two arrangements. Includes the article’s brief mention of temporary coverage concepts and modifier usage.
What You Will Learn
- The general purpose of Medicare incident-to billing
- The kinds of physician-enrollment delays that prompt consideration of incident-to
- The broad supervision and practice-relationship themes discussed in the article
- How the article distinguishes incident-to from locum tenens
- Why practices should avoid confusing temporary billing arrangements
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Physicians
- Revenue cycle staff
Codes Discussed
Modifiers Discussed
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