incident to billing question- help

ridenut

Networker
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62
Location
Silver Spring, MD
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0
ok - NP does vein therapy in our office while the doctor is also in the office suite. Should I use the Doctors or the NP NPI in box 24J for the highest reimbursement.
The NP has already assigned Medicare benefits to the practice NPI.

My understanding is that if the NP sees a patient while the doctor is not in the office I would bill the NP NPI in box 24J as the rendering provider.

Please help!
 

mitchellde

True Blue
Messages
13,538
Location
Columbia, MO
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2
The physician must also be the one that has previously seen this patient for this problem and has a written plan of care for the treatment being rendered by the NP, as well as being on site. If all those stars line up for you then yes you may bill the service as incident-to. If even one criteria is missing then you bill under the NP.
 
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