tci ED Coding & Reimbursement Alert - 2005 Issue 9

READER QUESTIONS: No 'Incident-To' in ED

Question: If nurse practitioners (NPs) are employed by the emergency physician group rather than the hospital, can the physician group bill for an NP's services as -incident-to,- or does the group have to bill under the provider number of the NP?California SubscriberAnswer: In general, the incident-to provision is not allowed in the emergency department. Services provided by techs, nurses, or other hospital employees are reimbursed to the hospital through Medicare Part A, not through billing Medicare Part B on behalf of the physician.However, in this case, the NP is employed by the physician group, so there...

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