Wiki -SA Modifier

[mforsyth]

Hi all! We have a scenario where the doctor wants to bill for the NP seeing the patient under his NPI with the -SA modifier even when he is not in the office at the time of the service. I know Medicare clearly states that the doctor must be in the office suite at the time of service but BCBS TX does not clarify this. Does anyone know what site of supervision requirements are for BCBS TX?

Any information would be helpful especially online materials like links and articles!

Thank you in advance!

 

[csperoni]

Billing incident-to does not seem appropriate if incident-to is not met. You should contact BCBS TX directly to determine if they follow incident-to guidelines. From my experience, most commercial carriers do contract with NPPs and want the billing under the NPP unless incident to.