Wiki "Incident To" Florida

Create Wiki
For Medciare patients you must follow CMS rules/guidelines. You would need to contact each of your payers to determine how they want NPPs billed. It varies by payer and by the state scope of practice for the NPP.

For instance, I'm from CT and Anthem B/C of CT will not pay incident to they want all claims billed under the NPP #, but Cigna (who does not credential PAs) wants them billed under the M.D. #.

I know it seems like a lot of work, but by contacting each payer (you already have Medicare's instructions from their manuals) and requesting in writing their policy for billing NPPs you will be able to be compliant. My company made a grid based on the responses we got and it has worked out well.
 
That is correct. There must be an established plan of care in order to bill incident too, Cleary on a new patient there is not. I am in Florida and I had a consultant speak on incident too guidelines in Florida at my chapters May Mania event

I d be happy to email you the presentation.
 
You must log in or register to reply here.
Top