tci Part B Insider - 2009 Issue 28

INCIDENT TO: Service Doesn't Meet Incident To Rules? Bill Under Non-Physician Practitioner's NPI

Don't take unnecessary risks for 15 percent more pay Do you know how the incident to rules apply to diagnostic services? The answer is, the incident to rules don't always apply to these services, but many medical practices aren't aware of that. And based on new scrutiny directed toward incident to claims, you should know the incident to rules inside and out. The OIG's recent discovery that unqualified non-physician practitioners (NPPs) performed 21 percent of incident to services is sure to have MACs scrutinizing your incident to claims very carefully (see page 217 for details on the OIG's report)...

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