Podiatry Coding & Billing Alert

Physician's authorization of NPP's services is a rule you can't miss.CMS recognizes nonphysician practitioners (NPPs) for payment purposes by reimbursing physicians for services provided "incident to" a physician's care. However, CMS has made it clear in 2008's Transmittal 87 that payers will not reimburse these services unless there is documentation authorizing the incident-to service.You could end up dazed and confused if you don't fully understand incident-to rules. But you can't afford not to -- Medicare reimburses at 100 percent of the physician fee schedule when billed incident to, and 85 percent when billed non incident to.Fortunately, you have ways to level up your knowledge about incident-to services. Here are 3 important guidelines.1. Meet CMS-Set CriteriaCMS' Benefit Policy Manual defines "incident to" as "services furnished as an integral although incidental part of a physician's personal professional service." CMS pays NPP office service reported under a physician's NPI at 100 percent, provided you [...]