Incident To And Split Shared Services Billing With Non-Physician Practitioners (NP and PA) Explained.

This lecture discusses incident to and shared/split services definitions and coding scenarios with physicians and non-physician practitioners (NPPs). I think it's important to understand how the Centers For Medicare& Medicaid Services (CMS) defines these terms before proceeding on with discussion of detailed coding scenarios. One Medicare carrier (link no longer active) provide a brief descriptions of both terms as well as a few scenarios from a Q&A session.Incident to billing is when a service is provided in an office setting by someone other than the physician. However, if the situation meets the guidelines, the physician may bill Medicare for the service. When incident to service requirements are met, the physician may collect 100% of the physician fee schedule amount. Services billed incident to are billed under the physician's provider number. Here is anothergreat review of incident to services.  Incident to services do not apply to inpatient situations. Since I am a hospitalist, I am not exposed to much incident to billing situations. But for readers who have discovered this post, I think it's important to continue their education for the rules. A complete review of CMS regulations regarding incident to services can be found at this link to the Medicare Benefit Policy Manualpdf file starting at60 - Services and Supplies Furnished Incident To a Physician ’s/NPP’s Professional Service (Rev. 1, 10-01-03) B3-2050...
Source: The Happy Hospitalist - Category: Internal Medicine Authors: Source Type: blogs