If the MD does not sign off, how is it indicated that it is an incident to visit (to justify the higher reimbursement)? since it would be billed under the MD in this case but the NP is the one who performed the visit?https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws is the best link I have ever seen to determine scope of work for Nurse Practitioners by state. That site indicates NPs in AZ do NOT need physician sign off by scope of work.
Incident to billing does not require the MD/DO to sign off on the note, but many practices have it done as a policy. As a reminder, for incident to billing, it must be an established patient, existing problem with an established plan of care. If your NP is seeing new patients, or new problems, it cannot be billed under MD/DO even if they sign off.