1. KStaten

    Billing X-Rays Separately

    If a NEW patient is seen by a PA or NP in an outpatient setting and x-rays are performed at the office (facility owns the equipment), and the PA or NP completes the HPI, exam, plan of care, etc, but the physician reviews/ dictates the x-rays, A) Can the x-rays be billed separately under the...
  2. KStaten

    Answer What qualifies as a "change" in the plan of care for Outpatient Incident-To Billing Rules?

    Hello Everyone! 🙂 Soo.... Incident-to Billing can be tricky, as even references sometimes vary in their wording/ interpretation of the rules. It has been to my understanding that any time a change is made in the physician's current plan of care, it no longer qualifies as incident-to services...
  3. K


    For incident-to, would you bill an APP's services under the physician who started the patient's treatment plan, or under the supervising physician who is available in the office at the time of services. Thank you!
  4. M

    New patient immunization or lab draw

    Our clinic sometimes sees new patients who only want a flu shot or and STD check. They only see the nurse. I know we can't bill any E/M codes for these situations, but can we bill these at all since they weren't seen by the provider? I'm a little confused about how incident-to billing works in...
  5. D

    I have a question regarding EMG billing

    My facility has an electromyographer (EMG tech) come to our office twice a week to perform EMGs. We have been billing the EMGs under the referring doctor. Most of the time that referring doctor is in the buildling at the time that the EMG is performed and this is billed as incident-to...
  6. H

    Physical Therapist Billing HELP!

    Hey billers out there! We have a Physical Therapist that has joined our group. We've been billing her services incident to the MD. He will be out of the office 2 days this month. Does anyone know if we are able to bill her services under the PA? The therapist is not currently credentialed with...
  7. O

    New Patient Visits

    I am a biller with a group in Tennessee, currently we have a system when a midlevel (NP) goes in and takes and documents the new pt encounter visit, goes out presents the case to the MD. He then goes in and finalizes the encounter and the plan w/ the new pt and we bill "incident-to" new pt visit...
  8. T

    Incident To

    I have 2 questions.... Under what conditions (and levels of supervision) can either the mid-level or the PT bill “incident to”? The bigger picture question: Can the PT and the mid-level can provide services at the second office location without a physician in the building, and if so, how do...