BC Advantage - 2022 Issue 8

Incident-To Services by Non-Physician Practitioners: What's Supported?

Incident-to is often discussed in coding and compliance circles, but when reviewing encounters, I routinely find the criteria fails to meet or support the billing of non-physician practitioners (NPPs) and/or other clinical staff (auxiliary).There are two types of incident-to services; a component of the service is being performed by a clinical staff member of the physician or non-physician practitioner (NPP), and a service being performed by a non-physician practitioner (NPP) as an integral part of a physician's course of treatment for the patient. This audit tip will focus on services performed by NPPs.Direct supervision is required by...

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