AAPC - Back to school
Results 1 to 3 of 3

Thread: Question about billing E/M visits for a teaching physician working with a resident

  1. #1

    Default Question about billing E/M visits for a teaching physician working with a resident

    AAPC: Back to School
    Does anyone have a physician who is working as a teaching physician with a resident at a hospital? Our physician is working with a resident and they are seeing patients in the hospital, as outpatients, so we are dealing with 99201 - 99205 and 99211 - 99215.

    When a teaching physician is working with a resident physician at the hospital, and the visits are billed under the teaching physician's name, what part of the visit must the teaching physician perform, if any? Or does the resident see the patient, and discuss the visit/plan of care with the teaching physician and all the charges are billed under the teaching physician's name as residents cannot bill?

    Sorry, I'm a little confused with how the billing is done in this situation. Because I am wondering if it's an established patient, then would "incident to" guidelines apply?

    But what happens when it's the resident performing the visit and the patient is new, so "incident to" would not apply - how are these visits then billed?

  2. #2
    Join Date
    Apr 2007
    Carmel, New York

    Default Teaching physician guidelines

    Instead of using incident-to, this sounds like you need to follow the teaching physician guidelines. Instead of trying to explain them all here, I am going to give you the link to where you can find them on CMS:



    2016 Secretary
    Ellenville, NY Local Chapter

  3. #3


    Thank you - that helped a lot!

Similar Threads

  1. Help! Teaching Physician and Resident services
    By Love Coding! in forum Medicare Regulations
    Replies: 2
    Last Post: 04-09-2015, 12:08 PM
  2. Resident / Teaching Physician ratio?
    By Cathy.R in forum Medicare Regulations
    Replies: 0
    Last Post: 01-07-2015, 12:22 PM
  3. Replies: 4
    Last Post: 02-11-2009, 01:43 PM

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.