Practice Management Alert

You can save your practice money by knowing the details of "incident-to" billing. Use these five easy guidelines to determine when you can and cannot bill under the physician's ID number for services a physician assistant provides incident-to the physician's services:

1. Use the physician's ID number to bill incident-to when:

A. the physician is present in the office when the patient is seen,
 
B. the patient is an established patient who is being treated under the physician's plan of care, and

C. the physician's office is the location where the patient is seen.

2. Bill under the PA's ID number if all three of the above criteria are not met.

3. Bill under the PA's ID number if the patient is established but presents with a new problem not previously treated and is seen by only the PA.

4. When a PA assists the physician at surgery, bill the PA's services using the PA's ID number. Otherwise, two charges will show up under the physician's number -- one for surgeon and one for assistant surgeon -- and that will confuse payers.

5. Check with individual carriers to determine exactly how they would like assistant charges reported. Many carriers want modifier -AS (Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery), while others want modifier -81 (Minimum assistant surgeon) or modifier -80 (Assistant surgeon).