Pulmonology Coding Alert

Question: Is there any circumstance in which a group can bill all services and all providers (including other physicians) under just the medical director? I know we can bill nonphysician practitioner (NPP) services incident to another physician. What about to other physicians? California Subscriber Answer: No, you cannot always bill services for all providers under a group's medical director. One reason is because you may not bill one doctor incident to another doctor. Incident to rules don't apply here because they pertain to care rendered by an NPP incidental to the plan of care established by the physician. The NPP must have an identifiable relationship with the physician (such as a leased or direct employee of the group practice). Bottom line: It is never acceptable to bill services provided by one physician under another physician's name or national provider identifier (NPI). Physician billing under the name of a physician who [...]