Incident to - when the initial physician is out of office

Colliemom

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I have a question for you all....

Say it is a two physician practice. Dr Smith performs the initial visit and develops the plan of care. Then the patient comes in and is seen by the PA - so we can bill "incident to" if Dr Smith is on site. Now what if Dr Smith is out of the office, and his partner Dr Jones is in the office supervising the PA. Since Dr Smith developed the plan of care, can we still bill "incident to" under Dr Smith, even though it is Dr Jones in the office that day?

My understanding is that we can bill "incident to" when any physician in the group is present in the office to supervise the PA. But my adminstrators want to clarify the issue further. Since Dr Smith developed the plan of care, but Dr Jones is supervising on the day of the appointment, do you bill the "incident to" visit under Dr Smith or Dr Jones?

My feeling is that we would have to bill under the supervising physician's name, even if another physician within the practice developed the plan of care. So what are your opinions?
 
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LLovett

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CMS sees physicians of the same specialty in the same group as the same person. So as long as both doctors are of the same specialty you can have the PA working incident to the other doctor. Since they have to be on site to bill you would bill it under the provider that was physically there even though they were not the one that initiated that course of treatment.

Laura, CPC, CPMA, CEMC
 

g.fairchild

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CMS sees physicians of the same specialty in the same group as the same person. So as long as both doctors are of the same specialty you can have the PA working incident to the other doctor. Since they have to be on site to bill you would bill it under the provider that was physically there even though they were not the one that initiated that course of treatment.

Laura, CPC, CPMA, CEMC
I agree with Laura we have been doing this for years in our office, and we have several Physicians and CNP's...we have always billed under the Physician on site that particular day.
 
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