tci Medicare Compliance & Reimbursement - 2009 Issue 3
PART B REVENUE BOOSTER: Recognize Incident-to Services Or Pay The Price
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Article Overview
This article reviews incident-to billing under Medicare Part B and explains why the topic matters for practices using nonphysician practitioners. It focuses on the general requirements for physician presence and supervision, how payer audits may review scheduling and chart documentation, and why compliance attention from the OIG makes this area important for billing staff and practice managers.
Why This Topic Matters
Incident-to billing can affect whether services are paid at the full physician rate, and mistakes can trigger denials, audit scrutiny, or compliance problems. Practices need a clear understanding of the operational and documentation issues discussed in the article to reduce risk.
What You Will Learn
- How incident-to billing is presented in the context of Medicare Part B
- Why physician presence and supervision are relevant to incident-to services
- What kinds of audit and compliance concerns are associated with incident-to billing
- How the OIG’s focus on incident-to services affects practice oversight
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance personnel
- Physicians
- Nonphysician practitioners
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