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Printed Date: 9/22/2015
"Incident to" services are defined as those services that are furnished incident to physician professional services in the physician's office (whether the office is located in a separate building or is an office within an institution) or in a patient's home.
These services are submitted as Part B services to Palmetto GBA as if you personally provided them and are paid under the physician fee schedule.
Note: "Incident to" services are also relevant to services supervised by certain nonphysician practitioners such as physician assistants, nurse practitioners, clinical nurse specialists, nurse midwives or clinical psychologists. These services are subject to the same requirements as physician-supervised services. Remember that incident services supervised by nonphysician practitioners are reimbursed at 85 percent of the physician fee schedule.
For clarity's sake, this article will refer to physician services as inclusive of nonphysician practitioners.
The following paragraphs discuss the various care settings, which are important to note because the processes for billing vary somewhat depending on the care site.
Hospital or SNF
Offices in Institutions
In Patients' Homes
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Last Updated: 05/28/2020