Results 1 to 4 of 4

Incident to billing (MD and PA-C)

  1. Default Incident to billing (MD and PA-C)
    Medical Coding Books
    Can someone please clarify exactly what is expected of the Physician, when during office hours, a PA-C primarily treats the patient, but it is billed under the Physician's name/npi? Or direct me to where I can find this in writing? (We'll use Medicare as the insurer in this example) Thank You!

  2. Default
    You can get incident to rules on medicare's website. Also, if you do a search through previous posts, incident to rules have been covered on AAPC.

  3. Default
    I've printed and read different articles from CMS and Highmark on incident to billing; I just dont see anything that states exactly how much involvement the physician must have in order to bill the service under his name/npi rather than the Pa-c's info.
    I will search previous threads as you suggested. Thanks so much for your reply!

  4. #4
    Columbia, MO
    if you look in the Medicare manual section 2050 it will state that the physician must have already seen the patient for the exact same reason and there must be a plan of care then written by the physician to include any followup encounters and the physician you are billing under must be within the office suite are while the patient is being seen. Therefore it cannot be a new patient or new problem and be billed under the physician.

    Debra A. Mitchell, MSPH, CPC-H

Similar Threads

  1. Replies: 3
    Last Post: 10-26-2016, 11:10 AM
  2. Incident to billing
    By kellyal in forum Family Practice
    Replies: 0
    Last Post: 08-29-2013, 12:38 PM
  3. Incident to billing - orthopaedic practice
    By doodiebuggy in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 04-18-2011, 11:22 AM
  4. Replies: 0
    Last Post: 09-23-2009, 11:18 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.