Wiki Split/Shared Billing VS Incident-To

[CruzMich]

Good morning!
I haven't had to bill Incident-To billing in many years. As we know billing and coding changes at the drop of a hat. My provider I bill for is a primary care provider. He has an office where patients see him twice a week and then he will go to the Assisted Living Facilities where a lot of our patients live. He at times will do a telehealth visit with the assistance of a nurse there. My question is, I understand in the office when his NP will see his patient for a follow up visit can be an "incident-to" however in the Assisted Living it is considered "split/shared"? Is this correct. I need to refresh myself pretty quickly here. Thank you all ahead of time.

 

[jkyles]

Hi there. It is confusing and there have a been a lot of changes to split/shared services in the past three years.

But under Medicare's rules, follow up care by a nurse who works for the ALF is not a split/shared visit. I recommend checking your MAC's guidance on incident-to and split/shared services and going over them with your provider.

www.novitas-solutions.com/webcenter/portal/EvaluationManagement_JH

Novitas even has a handy incident-to tool.