Wiki "Incident to" Billing question

[ebentley05]

Good Morning, I work at a Pediatric office and our providers go and do rounds in the morning at the hospital for Newborns. Is a PA able to go see the newborns in the hospital setting without the supervising provider and still bill under them since they will review the notes?

 

[thomas7331]

No, "incident to" billing is only allowed in the office. In a facility setting the visit would need to be billed under the PA's credentials unless it met the definition of a "split/shared" visit. Just reviewing the notes is not sufficient for the service to be a split/shared visit.

 

[csperoni]

Agree with @thomas7331. This cannot meet incident-to in the hospital setting. Your PA can absolutely round on the patients, and you can absolutely bill for those services. You just bill them under the PA.
In fact, EVEN IF this were the office setting, it would likely not meet incident-to unless the PA is following an established plan of care and the physician is onsite.