Podiatry Coding & Billing Alert

Question: Is there any circumstance in which a group can bill all services and all providers (including other physicians) under just the head doctor? I know we can bill NPP services incident-to another physician, but what about other physicians? Wisconsin Subscriber Answer: No, you cannot always bill services for all providers under one of the group's medical doctors. One reason is because you may not bill one doctor incident-to another doctor. Incident-to rules don't apply here because they pertain to the relationship between a physician and a nonphysician practitioner (NPP). Bottom line: It is never acceptable to bill services provided by one physician under another physician's name or national provider identifier (NPI). Billing under the name of a physician who did not perform the service can lead to problems including false claims submission allegations. You can, however, report NPP services incident-to the medical director if the visits meet all the [...]