Checklist to Help Improve Compliance with Incident-to Billing Requirements

Medicare has precise requirements for billing incident to the physician’s services, which allows practices to charge 100% of the physician fee schedule for services performed by nonphysician practitioners (NPPs) instead of 85% when they’re billed under the NPPs’ national provider identifier. The requirements are summarized in this checklist, which was created by Jean Acevedo, president of Acevedo Consulting in Delray Beach, Florida. There have been several recent false claims settlements for alleged violations of the incident-to rules.[1] Contact Acevedo at jacevedo@acevedoconsulting.com.

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