Medicare Compliance & Reimbursement

Follow these tips to ensure you're reporting Incident-to properly. As most Part B practices are aware, under incident-to rules, qualified nonphysician practitioners (NPPs) can treat certain patients and still bill the visit under the doctor's National Provider Identifier (NPI), bringing in 100 percent of the assigned fee. But nailing down the complex incident-to regulations can sometimes trip up even the most seasoned coder. Bill your incident-to services properly every time with this expert advice. How it works: When an NPP provides a service to a Medicare patient incident-to the physician, you can report the service under the physician's national provider identifier (NPI) as long as all of the Medicare rules for incident-to services are followed. Doing so will net 100 percent pay for the service. When you bill for the NPP's service under the NPP's own NPI, however, you'll receive 85 percent of the full rate. Be on the lookout [...]