incident to billing

  1. C

    Wiki INCIDENT TO PROVIDER

    Hello, Medicare in the final rule had mentioned that LMFT,MHC would not require incident to provider. However there are many carriers that are denying such implementation, or like Tricare that said that they have yet to update on their end. I was wondering if there's a website or place were I...
  2. T

    Wiki What are considered Medicare b Auxiliary Personnel for welcome to Medicare physical and risk assessment

    Hi Folx, We are a HIV/LGBTQ+ integrated care clinic who is partially funded by grants. We have received a grant that focuses on people living with HIV who are becoming eligible for Medicare b. The grant specifically focuses on the Welcome to Medicare physical and risk assessment. The grant...
    • Troykall1
    • Thread
    • ancillary staff incident to billing medicare b medicare billing physical exam
    • Replies: 0
    • Forum: Medicare Regulations
  3. M

    Wiki Do other payers allow incident-to billing?

    Is Medicare the only payer that allows incident-to billing? I can't seem to get a straight answer from anywhere I've looked. We have medical assistants who perform injections and blood draws but I don't know if we can bill those services as incident-to to all payers or just Medicare.
  4. F

    Wiki Outpatient Nurse visits

    Can nurse visits be rendered and billed under standing orders, when the standing orders is generic to all patients dependent on fixed criteria? For example, any patient that comes in with diabetes can be seen by a RN for diabetes education (including glucose), without being referred specifically...
    • Feather
    • Thread
    • incident to billing nurse visits out patient primary care standing orders
    • Replies: 0
    • Forum: Family Practice
  5. B

    Wiki Incident To Billing in Primary Care

    Can anyone give specific examples on instances when incident to billing is and isn't allowed? The language on Medicare's website is not very specific. What are the charting requirements needed in order to bill incident to? Thank y ou!
  6. T

    Wiki Incident-To Billing for new PA

    Hello, We have a new physician assistant that joined our group. We are waiting on her credentialing to be finished up with several payers. If the supervising physician is on-site and incident-to requirements are met, and the supervising physician is in network and credentialed with a payer...
  7. M

    Wiki -SA Modifier

    Hi all! We have a scenario where the doctor wants to bill for the NP seeing the patient under his NPI with the -SA modifier even when he is not in the office at the time of the service. I know Medicare clearly states that the doctor must be in the office suite at the time of service but BCBS TX...
  8. KStaten

    Wiki Physician's Presence Requirement for Incident-To Billing

    Hello Everyone! :) I would appreciate confirmation on a couple rules regarding "incident-to" billing, as I have heard some variations over the years. 1) It is to my understanding that the physician who established the plan of care MUST be present in the same office (same floor)/suite in...
    • KStaten
    • Thread
    • group incident to billing nurse practitioner physician's presence physicians assistant plan of care specialty
    • Replies: 1
    • Forum: Medicare Regulations
  9. KStaten

    Wiki What Designates an "Active Involvement" in Plan of Care?

    Hello Everyone! 🙂 According to what I have read (in regards to incident-to billing), in order for a patient to be seen by the PA and still be billed under the doctor, the doctor must do the following: 1) Initiate the treatment 2) Continue to be "actively involved" in the patient's case/ plan...
    • KStaten
    • Thread
    • active treatment actively involved documentation frequency incident to billing medicare guidelines phycisian's assistant physician plan of care time
    • Replies: 2
    • Forum: Medicare Regulations
  10. KStaten

    Wiki Who Has Documentation Permissions per Medicare Guidelines?

    Hello Everyone! :) I am trying to put a table together to describe components of a medical document for a typical outpatient setting office visit and list who (per Medicare guidelines) has permission to document each one. In other words, in order to correctly bill under the physician, what...
    • KStaten
    • Thread
    • ancillary staff documentation e/m documentation established patient hpi incident to billing medical record medicare guidelines new patient phycisian's assistant
    • Replies: 6
    • Forum: Medicare Regulations
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