tci Medicare Compliance & Reimbursement - 2010 Issue 5

READER QUESTION: Consider Using Incident-To Guidelines When Billing Follow-Ups

Know the rules before you try to bill incident-to. Question: One of our non-physician practitioners (NPP) saw a patient during a follow-up visit -- what is required in order for us to report these services to Medicare as incident-to the NPP?Answer: To qualify for incident-to, the NPP must have seen the Medicare patient during a prior visit and established a clear plan of care. If the NPP is treating a new problem for the patient, or if the doctor has not established a care plan for the patient, then you cannot report the visit incident-to.Important: When meeting...

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