AB87
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it
Source: CMS
Source: CMS
Last edited:
I just started a job and i have came to realize that some of these claims do not follow the incident to Rules!!!My Manager is telling me that in the state of florida a NPP (ARNP/PA) can see new patients and bill under the Doctors Number! When i read these Guidelines time after time it states that the Doctor must see a new pt and make a treatment plan, then the PA/ARNP can render services (incident to) as long as its for the same problem. Can someone show me something that says PA/ARNP can bill for new patients in the office setting and use the Doctors number? This person has not shown me where she got her Information from
This is From our FCSO Contractor in Florida
: If a new patient comes into the office and sees our physician assistant (PA), can our PA bill this as "incident to" the doctor, who is also in the office seeing patients?
A: No. In order for the service to qualify as "incident to," an initial encounter must have occurred between the doctor and the patient, and a course of treatment established by the doctor. In this situation, services performed by the PA do not meet the “incident to'” requirement and would not qualify.
Source: CMS Internet-only Manual (IOM) Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15 Covered Medical and otherHealth Services, Section 60 Services and Supplies Furnished Incident to a Physician's/NPP's Professional Service
You are correct . I had a consultant present on incident too at our May Mania event. My practice has two ARNP's so it was a topic near and dear to me as well.
After our seminar, I had to sit with the MD's and explain to them that changes needed to be made. Although they weren't happy, they understand that we must remain compliant.
I have the presentation available if you would like a copy.