ED Coding & Reimbursement Alert - 2014 Issue 2
Reader Question: Physicians Can't Bill Incident to Each Other
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Article Overview
This reader Q&A addresses a common physician billing scenario involving office coverage within a practice and asks whether an established patient visit can be billed under a different physician’s name or NPI. The article is relevant to physicians, practice managers, and billing staff who need a high-level understanding of incident-to billing limits, supervision concepts, and the compliance risk of billing services under the wrong provider.
Why This Topic Matters
Understanding the limits of incident-to billing helps avoid improper provider attribution and potential false claims exposure in physician practice billing.
What You Will Learn
- When incident-to billing is discussed in a physician practice setting
- How billing responsibility is framed when one physician provides the service and another physician is unavailable
- What general compliance concerns are associated with billing under a physician who did not perform the service
- The broad relationship between incident-to billing and services furnished by non-physician practitioners under supervision
Who Should Read This
- Physicians
- Practice managers
- Medical coders
- Billing staff
- Compliance staff
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