tci Part B Insider - 2003 Issue 9

INCIDENT-TO BILLING: Ask Your Local Carrier About Incident-To Requirements

How far away from a physician can nonphysician practitioners stray before incident-to billing goes away? The answer may differ by state. But in general, the physician must be on the same premises as NPPs to bill for their services on an incident-to basis. This doesn't necessarily mean in the same room, says attorney Alice Gosfield with Alice Gosfield & Associates in Philadelphia. Any physician in your group can perform this supervisory role, she adds. "For services to be billed incident-to, the physician must be in the clinic or suite immediately available to the NPP should a problem arise,"...

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