Last Modified: 9/20/2018 Location: FL, PR, USVI Business: Part B
Billing physician assistant services ‘incident to’ a physician FAQ
Q: If a new patient comes into the office and sees our physician assistant (PA), can our PA bill this as "incident to" the physician, who is also in the office seeing patients?
A: No. In order for the service to qualify as "incident to," an initial encounter must have occurred between the doctor and the patient, and a course of treatment established by the doctor. In this situation, services performed by the PA do not meet the “incident to’” requirement and would not qualify because this is a new patient. The claim would be billed listing the PA as the performing provider.
Source: CMS internet-only manual (IOM) Pub. 100-02 Medicare Benefit Policy Manual, Chapter 15 Covered Medical and other Health Services, Section 60 Services and Supplies Furnished Incident to a Physician’s/NPP’s Professional Service
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