Incident-To Guidelines for Nonphysician Healthcare Providers

Keep in mind that the above “incident-to” rules apply to Medicare reimbursement only. Private carriers may have different guidelines for reimbursement of NPP services. It is imperative for your staff to verify private payer coverage if a beneficiary is seen by an NPP.

Using the services of an NPP can be a great time saver and revenue booster to a practice, if all guidelines are followed. As always, documentation is the key to supporting all services performed in a practice, no matter who is performing the service.

For further information concerning “incident-to” guidelines or any coding matters, contact Melesia Tillman, CPC-I, CRHC, CHA at (404) 633- 3777, ext. 820, or [email protected].

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