tci Part B Insider - 2008 Issue 2

READER QUESTION: Straight From the Listserv--You Don't Need a Modifier for Incident-to Claims

Question: We recently hired a nurse practitioner and aren't sure which modifier we should append to our claim to report our services as -incident-to.- Can you please advise? Answer: Although Medicare carriers have strict guidelines for reporting incident-to services, using a modifier is not one of them. Neither CPT nor HCPCS features a specific modifier that applies to incident-to billing for Medicare patients.Correctly billing your nonphysician practitioners- (NPP-s) incident-to services means the difference between 85 and 100 percent reimbursement. But if you bill incident-to haphazardly, you could be inviting auditors- scrutiny. Your first step in collecting for...

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