In Billing
Sep 13th, 2019
Incident-to billing for advanced practice providers (nurse practitioners, physician assistants, clinical nurse practitioners, nurse midwives, etc.) has been available to limited license practitioners since 1998. And the rules for what is required to bill incident-to are clearly defined by the Centers for Medicare & Medicaid Services (CMS). Yet, this privilege, which enables a limited license ...
In CMS
Dec 14th, 2018
Incident to billing allows non-physician providers (NPPs) to report services “as if” they were performed by a physician. The advantage is that, under Medicare rules, covered services provided by NPPs typically are reimbursed at 85 percent of the fee schedule amount; whereas, services properly reported incident to are reimbursed at the full fee schedule value. ...
In Coding
Aug 21st, 2017
When a non-physician practitioner (NPP) performs an incident to service, that NPP must follow the plan of care as prescribed. He or she may not independently change the course of treatment. This requirement appears in Chapter 15, Section 60 of the Medicare Benefit Policy Manual, as shown in bold text: … to have …[a] service covered as incident to ...
Part 1: Bolster the areas where your incident-to and shared billing falls short. There are several major issues facing compliance officers today, such as HIPAA, Stark Law, and Anti-kickback Statute issues, as well as many billing compliance issues. Billing issues continue to appear in federal government False Claims Act settlement agreements and government audit reports. ...
Oct 21st, 2015
By Michael D. Miscoe, JD, CPC, CASCC, CUC, CCPC, CPCO, CPMA Christopher R. Thyer, United States Attorney for the Eastern District of Arkansas, David Shepard, Assistant Special Agent in Charge for the Little Rock Field Office of the Federal Bureau of Investigation (FBI), and Special Agent in Charge CJ Porter of U.S. Department of Health and ...