Wiki Can we bill "incident to" if the doctor just steps in the room

[CatchTheWind]

If a PA sees a patient who has a new complaint (or an existing condition that requires a new plan of care), does Medicare allow "incident to" billing if the doctor merely steps into the room to confirm the PA's diagnosis and plan (and then signs the chart)?

 

[mitchellde]

No this cannot be incident to. It could be a shared encounter but the provider must examine the patient and write a separate note detailing his findings and including then having reviewed the PA note. The regulations are clear that signing off on the PA note is insufficient to be able to bill as a shared encounter under the physician NPI, and it does not meet the definition of incident -to, therefore you must bill using the PA NPI in field 24J as the rendering provider.