tci Medicare Compliance & Reimbursement - 2011 Issue 13

Can You Bill All Services as Incident-to Under One Physician's ID Number?

Incident-to rules apply to the relationship between a physician and a mid-level provider. If your group practice made an administrative decision to simplify the medical records by billing all services and all providers (including other physicians) under just the medical director's NPI, you could be headed for trouble. You cannot always bill services for all providers under a group's medical director. One reason is because you may not bill one doctor incident-to another doctor. Incident-to rules don't apply here because they pertain to the relationship between a physician and a midlevel provider (MLP), also known as a nonphysician practitioner...

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