decisionhealth Newsletters, Answer Books - 2007 Issue 10 (October)
Answer_Book / Welcome_to_Medicare_Exams / Bill_incident_to_for_Welcome_to_Medicare_follow_ups_only
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Article Overview
This article discusses Medicare billing policy around follow-up care after a Welcome to Medicare exam, with emphasis on incident-to billing and shared visits. It is aimed at clinicians, office staff, and coders who need to understand how later visits, provider roles, and plan-of-care timing affect billing compliance. The article focuses on general Medicare requirements, practitioner types, and the difference between the initial preventive visit and subsequent medically necessary follow-up services.
Why This Topic Matters
Properly distinguishing the initial Welcome to Medicare exam from later follow-up care helps practices avoid billing errors and compliance problems. The article highlights provider-role limitations and the need for a pre-established plan of care when billing later services.
What You Will Learn
- How incident-to and shared-visit concepts relate to follow-up care after a Welcome to Medicare exam
- Which provider roles are relevant to the initial visit and later follow-up services
- Why the timing of a plan of care matters for billing later services
- How practitioner type affects whether the initial preventive visit may be performed under a provider number
Who Should Read This
- Medical coders
- Billing staff
- Compliance staff
- Physicians
- Non-physician practitioners
- Practice administrators
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