The term "Incident to" pertains to Medicare only - Physician Assistants can bill independently (under their own provider number) for commercial carriers following the general supervision rules. This means that the physician does not have to be present in the office / clinic at the time the independent service is being performed but must be available by phone. Typically there is no reduction in fee for these services.
Medicare will pay for independent services billed "incident to" performed by the PA providing it is not a new patient or consult, it is an established problem with an established treatment plan. If this criteria is not met than the PA must bill using their own provider number and is subject to 85% reimbursement.
Non Physician Practitioners such as PA's cannot bill "incident to"for hospital services related to Medicare patients.
Hope this helps,
Maria A. Candia CPC
- ICD-10 Trainings
- Comprehensive Courses
- CPC (Certified Professional Coder)
- COC (Certified Outpatient Coder)
- CIC (Certified Inpatient Coder) NEW!
- CRC (Certified Risk Adjustment Coder) NEW!
- CPB (Certified Professional Biller)
- CPMA (Certified Professional Medical Auditor)
- CDEO (Certified Documentation Expert – Outpatient) NEW!
- CPPM (Certified Physician Practice Manager)
- CPCO (Certified Professional Compliance Officer)
- VIEW ALL CERTIFICATIONS
Coding / Billing Solutions
- Audit / Compliance Solutions
Job Experience / Apprentice Removal
News / Discussion
- Other Resources
- Book Store
- Log In / Join