Incident to billing /Supervising Physician

donnalara

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Help, please!

On a claim form in box 24J when billing incident to, does the supervising physician name go there or does the rendering NP information go in the box?
 

SharonCollachi

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If you put the rendering NP's info, it wouldn't be billing "incident to".

Per Medicare:

Billing​

Services rendered 'incident to' a physician's service should be billed under the employing physician's NPI, or in the case of a physician directed clinic the supervising physician's NPI, and are reimbursed as if the physician performed the service (no modifier required). If the physician is non-participating, then the services can be billed as either assigned or non-assigned.

Services rendered 'incident to' a nonphysician practitioner's service should be billed under the employing practitioner's NPI, or in the case of a physician directed clinic the supervising practitioner's NPI, and are reimbursed as if the practitioner performed the service.

The following practitioners must accept assignment: PAs, NPs, CNSs, CP, CSWs, CRNAs, CNMs and Registered Dieticians. Since these practitioners must accept assignment, any services billed 'incident to' these practitioner must be billed as assigned.

Incident to billing is paid at 100% of the physician fee schedule, whereas the qualified practitioners billing under their own billing numbers are paid at 85% of the physician fee schedule. If service delivery does not meet all incident to criteria, but qualifies for billing by the practitioner, payment is made at 85% of physician fee schedule when billed by nonphysician practitioners or 100% of fee schedule when billed by therapists.
 
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