tci Part B Insider - 2010 Issue 9

READER QUESTION: Consider Using Incident-To Guidelines When Billing Follow-Ups

Know the rules before you try to bill incident-to. Question: One of our non-physician practitioners saw a patient during a follow-up visit -- what is required in order for us to report these services to Medicare as incident-to the physician? Answer: To qualify for incidentto, the physician must have seen the Medicare patient during a prior visit and established a clear plan of care. If the non-physician practitioner (NPP) is treating a new problem for the patient, or if the doctor has not established a care plan for the patient, then you cannot report the visit incident-to. Important: When...

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