Medicare Compliance & Reimbursement - 2009 Issue 4
Part B Revenue Booster: Recognize Incident-to Services Or Pay the 15-Percent Penalty
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Article Overview
This premium article reviews Medicare Part B incident-to services and the compliance considerations that can affect how office visits are billed when nonphysician practitioners are involved. It is aimed at coders, billers, practice managers, and compliance staff who need to understand general incident-to rules, physician availability, audit risk, payer variation, and the OIG’s focus on this area.
Why This Topic Matters
Incident-to billing can affect reimbursement and audit exposure for physician practices. Understanding the general compliance themes discussed in the article helps practices avoid billing errors and better prepare for payer review.
What You Will Learn
- The general concept of incident-to billing under Medicare Part B
- The supervision and physician availability themes associated with incident-to services
- Why chart review and physician schedule documentation matter for audits
- How payer policies may differ from Medicare rules
- Why incident-to services are a compliance focus for oversight bodies
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office staff
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