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. ...
Be sure the practitioner is authorized to practice in your state and requirements are met. When working in an organization that bills for services performed by a nurse practitioner (NP) or physician assistant (PA), discussion may arise regarding limitations on the scope of practice for these non-physician practitioners (NPPs). Medicare provides coverage for services performed ...
In Billing
Mar 9th, 2015
For Medicare patients in the physician office, services performed by a qualified non-physician practitioner (NPP) must meet incident-to guidelines. For a service to qualify as incident-to: The NPP must be licensed or certified to provide professional health care services in the state where the physician practice is located. In most cases, the NPP must be ...
Learn the rules and track the time to receive Level 4 payment for these services. By Maryann C. Palmeter, CPC, CENTC Physicians and qualified non-physician practitioners (NPPs) spend a lot of time following up with patients, family members, and other caregivers to coordinate care. This time may be considered part of the coordination of care ...
In Audit
May 19th, 2014
Medicare allows coverage for services provided by Non Physician Practitioners (NPP’s) such as Nurse Practitioners (NPs) and Physician Assistants (PAs), per the following key principles. Qualifications To furnish covered services to a Medicare program beneficiary, Medicare requires that NPs: Be a registered professional nurse authorized by the State in which services are furnished to practice ...