Medicare Compliance & Reimbursement - 2016 Issue 6
Medicare: Incorrect Incident-to Billing Could Cut Into $$
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Article Overview
This article explains Medicare incident-to billing in a practice setting and why it matters for reimbursement, compliance, and claim reporting. It is aimed at coders, billers, and practice staff who need to understand when incident-to billing may apply, how supervision and plan-of-care requirements affect billing, and why payer policies can differ from Medicare. The discussion centers on general guidance for documenting and reporting services furnished by nonphysician practitioners under physician supervision.
Why This Topic Matters
Incident-to billing can affect whether a practice is paid at a higher or lower rate and whether a claim is billed correctly under Medicare or a payer that follows Medicare-like rules. Understanding the general requirements helps reduce avoidable billing errors and compliance risk.
What You Will Learn
- What incident-to billing is in a Medicare practice setting
- Why supervision and an established plan of care matter
- How payer policies can affect incident-to reporting
- What general documentation and claim-reporting considerations are discussed
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office staff
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