Wiki Incident To vs Locum Tenents

tlugg

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We are a specialty practice and we have one MD and one PA. Normally both providers are in the office together so we bill incident-to under the MD's provider number. Our physician is planning an extended vacation and we are facing the possibility of having to bill under the PA during that time and getting lower reimbursement. We share our office space with another MD, but he is not a part of our group. Our MD is asking if there is any way that the other physician could fulfill the supervising requirements for having an MD in the office suite. Could we consider him a locum tenens and still bill under our MD's provider number with the Locum Tenens modifier? My concern is that he is still seeing his regular patients at the same time.
 
The PA can only be incident to for the provider he is in a collaborative agreement with. You cannot always bill PA encounters under the MD, only those visits that meet the incident to definition. So these must be follow up encounters, no new patients, new problems, annual exams. So no there is no way to bill incident to a locum.
 
To clarify, our PA is in collaboration with the MD. Alll new patients and new problems do go through the MD. The PA just does follow-up.
 
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