Primary Care Coding Alert

Question: One of our non-physician practitioners saw a patient during a follow-up visit. What requirements must we meet to report these services to Medicare as incident to the physician?Florida SubscriberAnswer: To qualify as an "incident to" visit, the physician must have seen the Medicare patient during a prior visit for the same problem and established a clear plan of care, to which the follow-up visit provided by the non-physician practitioner (NPP) is related. If the NPP is treating a new problem for the patient, or if the FP has not established a care plan for the patient, then you cannot report the visit incident to.Remember: When meeting the requirements for a follow up to an established plan of care, if the physician does not directly supervise the NPP, the incident-to rules do not apply. Direct supervision means a supervising physician must be immediately available in the office suite. The supervising [...]