Wiki Non-Medicare Wellness Incident To

[coder2533]

I am trying to figure out if a wellness visit for commercial insurance can be considered 'incident to'. If they saw the provider for a wellness visit in the past and the provider noted that they need to return in one year for a wellness visit and they see an NP/PA can that be considered 'incident-to'?

 

[jorzano55@gmail.com]

I believe wellness vists in general have no connection or reasons that could valid a incident to situation. What would it be a incident to?

Since it is a commercial ins have you checked the pts benefits? Some companies and employers encourage preventative visits yearly. I know of a few companies that not only pay yearly benefits but also sent the patient a flat fee check for having their yearly exam. One patient got $50.00 every time she had a

 

[coder2533]

If the patient saw the physician for a wellness exam the previous year and documented that the patient should return the following year for a wellness exam, could the next year be considered incident to the first one? We have some commercial insurance companies that do not cover wellness visits for our NP/PAs but they do for the provider. We can bill incident to under the provider if we meet the incident to guidelines but I'm struggling to say that wellness visits qualify as incident to.