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Tag Archives: Incident

Billing a PA’s Services Incident to a Physician’s

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Use midlevel providers to maximize productivity and reimbursement in your physician office. Physician assistants (PAs) are a type of nonphysician practitioner (NPP) who may bill Medicare under their own national provider identifier (NPI). As of Jan. 1, 2022, PAs can bill and be reimbursed directly from Medicare where previously reimbursement could only be made to […]

The post Billing a PA’s Services Incident to a Physician’s appeared first on AAPC Knowledge Center.

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Incident to experts needed!

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I have a question for any incident to experts. We are billing the therapists incident to our nurse practitioner who has seen the patient, created a treatment plan and routinely sees the patient for med management. This nurse practitioner is leaving the practice. Am I correct that we can bill under another nurse practitioner just as we would bill under a covering doctor if it was a doctor who established the treatment plan. It’s been suggested that we can bill under the doctor because he signs off on the treatment plans but I don’t think that is correct. What about billing under a PA in the office as the supervising if a nurse practitioner established the treatment plan? Thoughts?

Medical Billing and Coding Forum

well checks – incident to billing

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Can anyone tell me if a nurse practitioner billing "Incident To" can see pediatric patients for their annual well checks? When the patient comes in for the well check, they have a new complaint such as ear pain. Upon the exam by the APN, the pt is found to have otitis media and is prescribed antibiotics. If their is only 1 note and the supervising physician did not see the patient, just signed off as being present in the suite during the visit, should we just be billing for the well check? Or should the supervising physician go in to the room and address the ear problem and prescribe the meds? How would we handle this situation?

Medical Billing and Coding Forum

Incident to

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We have a PA that is running the obesity counseling and Ideal Protein management for patients, but sometimes they come in and are only seen by a nurse. She does document everything just as our PA does, but it is only signed by our RN.

The nurse spends time counselling the patient and documents it and bills a 9940x depending on that time spent. The PA will come in after and sign off on the chart.

My question is, can a RN bill this service or does she have to be seen and evaluated by the NP, PA, or physician in order for it to be billed?

She (the PA) says it’s incident to, but I’ve searched and can’t find anything to support this and that a PA can bill any incident to services. Any info would be extremely helpful!

Thanks!

Medical Billing and Coding Forum

Incident To- true or false?

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The NPP is able to perform visits for New Patients as long as the physician reviews and signs the document, and the NPP signs the document.
True or False?

If the NPP performs Initial Visit and Dr. Signs off on the document, 3 of 3 requirements were met between the Dr. and the NPP work performed, the service is billed to Dr. or PA?

Thanks!

Medical Billing and Coding Forum

Incident to

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Provider wants all his claims to be billed as incident to. Most of his claims do not meet incident to Medicare guidelines. I have educated him and management on incident to billing. He says everybody bills all claims incident to, but I have a problem billing claims incident to, that do not qualify. He seems to think that he can’t be audited. I feel I have done my part, but I refuse to bill claims out that are not truly incident to. PLEASE help should I bill these out at the providers request or find other employment? No one seems to think it’s a problem but me even with the Medicare guidelines.

Medical Billing and Coding Forum