Wiki credentialing question

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There are circumstances this is permitted.
For office visits, incident-to must be met. Here are some of the requirements:
1) Cannot be new patient or a new problem
2) Physician must be onsite and immediately available
3) Must be an established problem with a plan of care that the PA/NP is following
4) PA/NP must be employed by physician, or the same group that employs physician
Please note incident-to is Medicare guidance. Not all insurance payors follow the incident-to. Some payors that do accept incident-to want the claims billed with -SA modifier.

For hospital inpatient care, there are split/shared visit requirements, and include that the physician must also personally see the patient on the same day.

 
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