Forum - Questions & Answers

Oct 14th, 2009 - recyh

incident-to

When an NP treats a patient that has a new condition this is billed as non-incident to, but how would you bill a follow-up visit for the same patient who again sees the NP? I am confused because the NP is actually the one who established the plan of care for the patients condition and now that the patient is returning it would be an established condition and assuming the supervising physician is on site they would meet the incident-to criteria for the follow-up visit but what physician would you bill it under?

Oct 14th, 2009 - Codapedia Editor 1,399 

incident to

The follow up visit would not be incident to, because the physician didn't initiate the care.

Oct 16th, 2009 -

Incident-to

How does incident-to work with Preventive Medicine codes for Medicare patients when the patient is an established patient and the only reason for the visit is the preventive med.?

Thanks

Oct 16th, 2009 - nmaguire   2,606 

Incident To

Medicare does not cover preventive codes. There is no incident to for this encounter.

Oct 16th, 2009 -

Incident-to

What about when it's an established patient in your office and they have now become eligible for the "Welcome to Medicare" visit?

Oct 16th, 2009 - Codapedia Editor 1,399 

incident to

This would not meet the requirements of incident to.

Your NP and PA should have their own provider numbers and bill the Welcome to Medicare visit under those numbers.

There are two articles in the data base about incident to--review those, as well.

Since Medicare pays at 100% of the fee schedule for incident to services, you have to be careful to bill them correctly.



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