Everything You Want To Know About “Incident To Billing”
                     EVERYTHING YOU WANT TO KNOW ABOUT “INCIDENT TO BILLING”
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
EVERYTHING YOU WANT TO KNOW ABOUT “INCIDENT TO BILLING”
MGMA has reported that many physician-owned multi-specialty practices and 
groups often use non-physician providers (NPPs). According to the report, the 
reason is that the NPPs with the practices often generate higher income than 
physicians and are financially more viable.
NPPs, however, need to function directly under the supervision of a physician 
to provide billable medical services. Therefore, registered nurse aestheticians, 
surgeons, or physicians’ assistants can be included in the facility under the 
NPPs.
Further under the Medicare fee schedule, the NPPs’ medical practices can 
receive full payment and reimburse the amount for the services successfully 
by reporting the NPSS services under ‘incident-to’ for physician care.
But CMS has implemented strict and complex guidelines for incident-to billing. 
That’s why physicians must understand the rules of the medical billing 
procedures correctly to receive full payment from the insurers for the services 
rendered by NPPs. The physicians/ billing staff also need to be aware of any 
misapplying of the conditions in the incident-to billing. Misapplication of the 
condition in the medical billing and coding further increases the chances of 
coming under thHeT TCPSM://WSW’Ws. 2r47aMdEDaICrA LfBoILrL INfGrSaEuRVdICuESle.CnOMt/ claims.
EVERYTHING YOU WANT TO KNOW ABOUT “INCIDENT TO BILLING”
Hence, most centers that offer NPPs prefer to work with medical 
billing services to overcome the challenges of incident-to billing.
What Should Physicians Know About Incident-To Billing?
There is quite a bit of ambiguity in the term ‘supervising physician.’ The CMS 
states that a medical billing or supervising physician does not necessarily 
have to be the original physician or ordering physician on the patient’s case.
How Are Incident-To Services Coded?
Additional modifiers are not required when coding for incident-to-services. 
Instead, the standard CPT, HCPCS, and ICD codes can be used.
How To Be Incident-To Billing Complaint?
The failure to have proper incident-to-billing compliance can mean a massive 
amount of settlements being paid for the failure to comply with the rules. For 
instance, in February of 2020, a family physician in Ohio had to pay $285,000 
to settle the allegation of failure to supervise nurse practitioner services 
billed at a higher physician rate.
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
EVERYTHING YOU WANT TO KNOW ABOUT “INCIDENT TO BILLING”
Undoubtedly, training your staff and staying on top of the 
changing regulations can be a challenge. But simultaneously, 
when you partner with an expert medical billing and coding 
company that specializes in incident-to billing such as 24/7 
Medical Billing Services, you will soon experience the benefit of 
having NPPs service. Also, you can enjoy the benefit of having 
an efficient revenue management cycle in place for better ROI 
while increasing the scalability of your facility by outsourcing 
medical billing and coding.
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/
EVERYTHING YOU WANT TO KNOW ABOUT “INCIDENT TO BILLING”
About 24/7 Medical Billing Services:
24/7 Medical Billing Services is the nation’s leading medical billing 
service provider catering services to more than 42 specialties across 
the entire 50 states. You can rely on us for end-to-end revenue cycle 
management. We guarantee up to 10-20% increase in the revenue 
with cost reduction of your practice for up to 50%. 
Call us today at 888-502-0537 to know more on how we can help 
boost profitability for your practice.
Media Contact:
24/7 Medical Billing Services,
Ohio:
28405 Osborn Road, Cleveland, OH 44140
Georgia:
3001 Greenfield Drive, Marietta GA 30068
Tel: + 1 -888-502-0537
Email - [email protected]
HTTPS://WWW.247MEDICALBILLINGSERVICES.COM/