Stricter Incident-to Rules Could Mean Less Revenue for Practices

The doctor who initiates a patient's care will have to be in the office when patients are being seen by non-physician practitioners (NPP) if the practice wants to bill incident-to services, according to a CMS proposal in the proposed 2016 Medicare physician fee schedule.  

Currently, the physician supervising the incident-to service does not need to be the same one who originally saw the patient.  CMS seeks to remove a sentence in the regulation that allow that and replace it with the new policy.

That would mean more NPPs would bill directly to Medicare to receive 85% reimbursement as opposed to the 100% reimbursement a practice receives billing incident-to services. 

Read the full article by the DecisionHealth Staff on Part B News.