Wiki Physician Extender Well Visit & New OB

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Celebration, FL
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With all the "incident to" rules I wanted to inquire about physician extenders seeing annual well women.
Clearly, there is no "incident to" since it is an annual visit?
Also, on a newly pregnant patient does the MD have to do the pregnancy confirmation and the NPP/PA can then do all the subsequent visits incident to ?
What about global care ?
 
With all the "incident to" rules I wanted to inquire about physician extenders seeing annual well women.
Clearly, there is no "incident to" since it is an annual visit?
Also, on a newly pregnant patient does the MD have to do the pregnancy confirmation and the NPP/PA can then do all the subsequent visits incident to ?
What about global care ?
Incident to rules are applied by the payer. Medicare established these rules for their purposes, but some commercial payers have also adopted them. However, the majority of time this concept is applied to sick, not well visits. If the patient is established with you and this is not her initial annual with your practice, you should be fine billing. If the payer specifically has rules with regard to direct billing by a PA (ie, does not allow), then the MD provider will have to be involved in the visit to get paid in most cases. The global concept was never meant to deal with "incident to" services per se. It is a recognition that many providers may render care during the pregnancy and there will be a single billing provider.
 
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