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tci Part B Insider - 2005 Issue 7

Incident-To Billing: Court Upholds Incident-To Supervision Requirement

Medicare has the right to require a physician to personally supervise non-physician practitioners when they're billing for services under the physician's number on an incident-to basis, a court ruled.The 9th U.S. Circuit Court of Appeals upheld a district court verdict that Dr. Gary Gibbon must repay $600,000 for nurse and therapist services he billed incident-to his own provider number between 1995 and 1997. Gibbon argued that the Medicare rule requiring his physical presence when he supervised these providers was invalid for a few reasons.1. First, Gibbon said that the current definition of "incident-to" came out...

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