Medicare Compliance & Reimbursement - 2010 Issue 9
READER QUESTION: Consider Using Incident-To Guidelines When Billing Follow-Ups
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Article Overview
This reader Q&A discusses Medicare incident-to billing for follow-up visits performed by non-physician practitioners. It outlines the general conditions involved, including prior physician involvement, supervision expectations, plan-of-care considerations, and practitioner qualification issues. The article is relevant to medical coders, billing staff, compliance personnel, and practices that bill Medicare for evaluation and management services.
Why This Topic Matters
Incident-to billing affects how follow-up professional services are reported and which billing provider is used, so understanding the general requirements helps practices reduce claim errors and compliance risk.
What You Will Learn
- The general Medicare incident-to framework for follow-up visits
- How prior physician involvement and a plan of care factor into incident-to billing
- Why supervision and practitioner qualifications matter for these services
- How billing under the supervising physician relates to reporting of follow-up care
Who Should Read This
- Medical coders
- Billing staff
- Compliance personnel
- Physician practices
- Non-physician practitioners
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