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BC Advantage - 2018 Issue 6

Auditing Incident to Services

Incident-to services allow non-physician practitioners (NPPs) such as nurse practitioners and physician assistants to bill under a supervising physician if they perform services that are incidental to a physician-created plan of care.Incident-to billing offers two key benefits: First, the physician is reimbursed at 100% of the contracted rate with the payer, while NPPs typically are reimbursed at 80% or 85% of the contracted rate, so if an NPP can bill under the physician, the reimbursement is higher. Second, billing under the physician allows a non-credentialed NPP to see patients, barring any payer-specific rules that may require the NPP...

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