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Make Sure You Are in Compliance with 'Incident To' Billing Practices
Posted on: 2/23/2018

Physicians often hire advanced practice registered nurses, physician assistants, psychologists or other health care professionals to provide services to patients under their clinical leadership.


When it comes to billing for professional services provided by a non-physician, the services can sometimes be billed by the physician supervising the services. In other words, in certain circumstances, if the services were provided “incident to” the physician’s own delivery of care, the services can be reimbursed at 100 percent of the physician's fee schedule.

But there are rules and regulations that must be followed for "incident to" billing in order to avoid a potential audit and recoupment by both private and public payers.

That's why ISMS offers an Issue Brief, "Incident To" Explained, which covers the very specific conditions that must be met to bill non-physician services as "incident to." 

If you need personal assistance, ISMS members and their practice management professionals may contact our advocacy team with questions by calling 800-782-4767 ext. 1470, or by sending an email.

As a member benefit, this Issue Brief is password protected.

If you need to request a username and password, contact online support at 888-476-7776 or onlinehelp@isms.org between 8:30 a.m. and 4:45 p.m. After-hours requests are answered promptly the next business day. You may also register online or retrieve your username or password.

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