ED Coding & Reimbursement Alert - 2009 Issue 31
READER QUESTION: Can You Bill All Services as Incident-to Under One Physician's ID Number?
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Article Overview
This reader question and answer discusses incident-to billing in a group practice setting. It addresses the difference between services furnished by nonphysician practitioners and services furnished by physicians, and it highlights the importance of payer rules, supervision, and practice documentation requirements. The article is aimed at medical coders, billers, and practice staff who need a general understanding of when billing under a physician identifier may be appropriate.
Why This Topic Matters
Improper incident-to billing can create claim risk and compliance exposure in a group practice. Understanding the distinction between physician and nonphysician practitioner services helps practices align billing with Medicare and other payer requirements.
What You Will Learn
- How incident-to billing relates to physician and nonphysician practitioner services
- Why group practices must distinguish between services performed by physicians and those performed by nonphysician practitioners
- What general practice and supervision factors affect whether services may be billed under a physician identifier
- Why state and Medicare guidance matters for incident-to claims
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office staff
Codes Discussed
Code Ranges Discussed
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