Wiki Incident to rules for secondary coverage

[DEDGE CGIC]

This question came up.
If a PA was billed to a commercial insurance primary under the supervising physician (incident to) and the patient has Medicare secondary which the PA is contracted is it still billable to Medicare under the supervising physician or does it need to be changed to the PA as the billing provider?
Any input or direction to policies on this matter will be greatly appreciated.

 

[mitchellde]

You should follow the incident -to rules for all payers unless you have a written policy from that payer that states you may bill under the physician when incident-to has not been met.
For any patient that has Medicare as a secondary you should follow incident-to rule. So as long as it is a follow-up visit while the physician is in the office you can leave it under the physician NPI.