tci Medicare Compliance & Reimbursement - 2022 Issue Q3

Reimbursement: Bolster Incident-To Coding With Care Plan

Review the Medicare billing rules to ensure claims success. You may think you understand all of the nuances about how to code incident-to services, but even one misstep can land you in hot water. Nuts and bolts: Medicare practices often use incident-to billing to maximize resources — and payment. This billing convention allows nonphysician practitioners (NPPs) to provide evaluation and management (E/M) services to patients without the physician’s accompaniment in certain situations. When allowed, reporting incident-to means that you can bill your NPP’s services under the National Provider Identifier (NPI) of the physician; this will garner you...

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