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Multi-Physician practice billing for a family member


Best answers
Our practice has 4 MDs. Dr. #1 is asking if Dr. #2 can see Dr. #1's spouse and bill for the services.
We bill under a group practice NPI.
Any thoughts?
Best answers
Not allowable to Medicare

Stark regulations prohibit billing family members of the physician (or the physician's associates) to Medicare. I believe if it is a private commercial plan, it is permitted, but you may want to check with an attorney. My personal opinion is that if it's just a visit or 2 & nothing extensive, to provide the services and not bill it to insurance because anything you pay to an attorney will far exceed your insurance payment.