Wiki Incident To

[KaylaRieken]

If a physicians assistant sees an established patient under the supervision of a doctor and is ordering a ct scan and bone scan for an established problem; can that be billed under the doctor or does that have to be billed under the physicians assistant?

 

[Chelle-Lynn]

It would depend on if the order is part of the plan of care that the physician originally set up for the patient. If the PA is seeing the patient for an established plan of care set by the physician and the plan discussed the possibility of scans or that the scans would be considered as a normal part of the care of the patient then it would be billed as incident to.

CMS defines incident to as:
Incident to is defined as services or supplies that are furnished incident to a physician's professional services when the services or supplies are furnished as an integral, although incidental, part of the physician's personal professional services in the course of diagnosis or treatment of an injury or illness and services are performed in the physician's office or in the patient's home. To qualify for payment under the incident to rules, services must be part of the patient's normal course of treatment, during which a physician personally performed an initial service and remains actively involved in the ongoing course of treatment.


Services performed by these nonphysician practitioners 'incident to' a physician's professional services include not only services ordinarily rendered by a physician's office staff person, but also the services ordinarily performed by the physician himself or herself such as minor surgery, setting casts or simple fractures, reading X-rays and other activities that involve evaluation or treatment of a patient's condition.