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Thread: Incident-to Question

  1. #1

    Question Incident-to Question

    AAPC: Back to School
    Per CMS in order to report code 99211, you must meet the incident-to requirments. Pt must be evaluated by a provider, the provider must order the service, and there must be physician supervison when the 99211 service is provided.

    I was listening to a webinar from a CMS contrator last week on incident-to services and according to CMS when the 99211 service is performed, it is reported under the supervising provider. For example, if Dr. A and Dr. B were in practice together, and Dr. A saw the patient and ordered weekly BP checks and the patient presents for the BP checks and Dr. A is gone, but Dr. B is the supervising, then you report the service under Dr. B.

    Our question is this....what if there are four doctors in the practice (Drs. A, B, C, and D). Dr. A orders the service. The pt comes into the clinic and the nurse performs the service, but Dr. A is gone that day. But, Drs. B, C, and D are present. Which one do you bill under?

    Hope this question makes sense.
    Last edited by dballard2004; 04-27-2011 at 08:41 AM.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

  2. #2
    Join Date
    Apr 2007
    North Carolina


    This may become a practice decision. Some of the Medicare seminars I've attended recommended assigning one supervisor for the day, if possible.

    "In highly organized clinics, particularly those that are departmentalized, direct physician supervision may be the responsibility of several physicians as opposed to an individual attending physician. In this situation, medical management of all services provided in the clinic is assured. The physician ordering a particular service need not be the physician who is supervising the service. Therefore, services performed by auxiliary personnel are covered even though they are performed in another department of the clinic."


    Page 5

  3. #3


    Thanks so much!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P
    Compliance Auditor

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