Wiki NPP "Incident To" Billing

[jessmtxstate]

We would like to begin billing our Nurse Practitioner's services to Medicare as "incident to", do we need a modifier to distinguish these services (such as -SA) for services performed in office? Does the .EHR medical record need to have the supervising physician's sign off (physician's signature on final document) to support these services?

 

[Lukelie]

As long as the guidelines to incident to are met, then the NPP can write the note and sign the note. The supervising provider should sign the note as well and enter the orders so the claim goes out under the supervising and not the NPP. There is no signature requirement for the supervising provider but its a good practice. Medicare University has a good webinar for incident to billing.

 

[teresabug]

PA's notes do NOT have to be co-signed by the supervising physician. As part of you billing "incident-to", you are already telling the payer that the physician is overseeing the treatment that the PA is rendering.

I strongly suggest viewing the plethora of information on this subject on www.wpsmedicare.com for the most accurate information. There are many rules to this guideline. Your billing software should have an area in it where the staff person will mark "incident to". Whatever physician is in the office that day, his name will be listed as the supervising and the PA's name will be listed as the rendering. If a physician is not in the office, you have to bill under the PA's name and get paid at 85% not 100% of the fee schedule.

also, I would hate to have a provider be doing extra work, such as co-signing notes, when it is not necessary.