tci Part B Insider - 2015 Issue 8

Incident To: Appropriate Incident-To Billing Requires Keen Understanding of 'New Medical Condition

Remember that not all payers follow the same rules. A new condition to you may not be new to the patient—so does incident to billing apply? This is one tricky question that may be on your mind following our recent article “3 Facts You May Not Know About Incident to” (see the Insider Vol. 16, no. 6). Check out the solution to this dilemma about using non-physician practitioners (NPPs) in your practice. One reader posed a question about the key phrase “new medical condition” in the CMS incident-to billing guidelines. CMS states, “The physician should...

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