Wiki incident to services - office setting

[dlentschjohnson]

I need clarification on incident to services in the office setting. Can a Nurse Practitioner see a new Medicare patient? Or only established patients?

 

[elleyl]

If you are billing the nurse practioner's services under the physician's NPI then the NP cannot see new patients.


A NP can see new patients but only if they bill these services only under her/his own NPI number.

 

[Naveen Rachagolla]

Yes. I agree with Elle
Go through this you might get some idea

Medicare Claims Processing Manual
Chapter 12 - Physicians/Nonphysician Practitioners

30.6.4 - Evaluation and Management (E/M) Services Furnished Incident to Physician’s Service by Nonphysician Practitioners
(Rev. 1, 10-01-03)
When evaluation and management services are furnished incident to a physician’s service by a nonphysician practitioner, the physician may bill the CPT code that describes the evaluation and management service furnished.
When evaluation and management services are furnished incident to a physician’s service by a nonphysician employee of the physician, not as part of a physician service, the physician bills code 99211 for the service.
A physician is not precluded from billing under the “incident to” provision for services provided by employees whose services cannot be paid for directly under the Medicare program. Employees of the physician may provide services incident to the physician’s service, but the physician alone is permitted to bill Medicare.
Services provided by employees as “incident to” are covered when they meet all the requirements for incident to and are medically necessary for the individual needs of the patient.

And also refer to
Medicare Benefit Policy Manual
Chapter 15 – Covered Medical and Other Health Services
60.1
60.2
60.3

You will get to know more about incident to