Wiki NP/PA "incident to"

[mmagness]

We have recently spoke with the nurse practioners in our practice about established Medicare patient's with new problems and told them that they can not bill "incident to" for new problems/conditions that haven't already been addressed by the physician first. They have had mixed emotions and several questions.
The question that most would like to know is:

If a patient has a chronic condition which worsens and/or the symptom that the patient is coming in for is due to the chronic condition is it acceptable to bill "incident to" or should they bill under their own provider number?

Any thoughts and/or recommedations are welcome...

Thanks,

MM

 

[RebeccaWoodward*]

Below is a great link for this information. At the top, in the yellow boxes, select "Billing in in an office or clinic setting". Within that page is a link for frequently asked questions. This should answer all your questions. But to answer your question...if it is a new problem...The PA/NP would need to bill under their NPI if they choose not to bill under "incident to".



http://www.aapa.org/gandp/3rdparty.html#billing