tci Medicare Compliance & Reimbursement - 2019 Issue Q3

Policy: MedPAC Proposal Aims to Nix ‘Incident To’

Hint: This could impact your bottom line. If your practice utilizes “incident-to” billing for care administered by nurse practitioners (NPs) and physician assistants (PAs), you may be looking at a Medicare pay cut down the road.  Reminder: Currently, when a non-physician practitioner (NPP) performs an incident-to service, the NPP can bill Medicare under the supervising physician’s National Provider Identifier (NPI), resulting in 100 percent reimbursement for the care. But if NPPs file services under their own NPIs, they are paid at only 85 percent reimbursement for the same service. As the policy stands, it translates to...

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