tci Medicare Compliance & Reimbursement - 2008 Issue 6

Reader Question: You Don't Need A Modifier For Incident-To Claims

For accurate NPP claims, keep an eye on the supervision rules Question:We recently hired a nurse practitioner and aren't sure which modifier we should append to our claim to report our services as "incident-to." Can you please advise? Answer: Although Medicare carriers have strict guidelines for reporting incident-to services, using a modifier is not one of them. Neither CPT nor HCPCS features a specific modifier that applies to incident-to billing for Medicare patients. Correctly billing your nonphysician practitioners' (NPP's) incident-to services means the difference between 85 and 100 percent reimbursement. But if you bill incident-to haphazardly, you could...

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