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Jurisdiction 11 Part B
Can an audiology service performed by an audiologist (technician) be submitted under the ENT physician's provider number when the ENT physician is out of the office on vacation? Could this be an example of 'incident to' services?

Answer:
No. The CMS Medicare Benefit Policy Manual Pub. 100-02, Chapter 15, Section 60, clearly outlines the criteria that must be met in order to submit 'incident to' services which includes "services furnished under the direct, personal supervision of the physician or non-physician practitioner."

In the scenario that you provided, the physician is not permitted to submit 'incident to' services while not on the premises and actively participating in the patient’s care. The services provided by the audiologist could only be submitted 'incident to' using the PTAN or NPI of the physician that supervised his/her service and must meet the definition of 'employee' of the submitting physician.

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last updated on 10/13/2014
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