Tag: Incident-To
Aetna Reverses NPP Payment Reduction
By: Hannah Wisterman ~ 2/12/25
On January 31st, InK reported Aetna was changing it’s policy on billing for Non-Physician Providers (NPP). As of February 10th Aetna has changed their stand. Please Read!
Aetna’s Feb. 10 reversal preserves NPPs’ ability to fully bill under a supervising physician’s name and National Provider Identifier (NPI) for services “incidental to” the physician’s diagnosis and treatment of an injury or illness. Services billed incident-to must be conducted in the same office suite where the physician is present and available to intervene if needed.
Incident-To Billing Got You Confused?
Texas Medical Association (TMA) can help!
“Incident-to” billing – when services delivered by a nonphysician practitioner are billed under a supervising physician’s credentials – can be confusing, and Texas Medical Association staff are routinely fielding questions about those unique arrangements.
To help you avoid any billing blunders, TMA has released an education sheet on incident-to billing (login required), with a basic overview of guidelines and requirements.
The two-page guide addresses incident-to billing for Medicare, Medicaid, and commercial plans, along with helpful links to resources that can help answer your questions and resolve billing snags.
Download the incident-to education sheet – along with other resources on billing, collection, claims, and more – on TMA’s Educational Quick Tips page.
The Rising Trend of Non-Physician Provider (NPP) Utiliaztion in Healthcare, 12/2016
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The Basics of Incident-to Billing, 11/23/2016
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Supervising Physician Should Bill Incident-to Services, CMS Clarifies, Part B News, 11/09/2015
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At A Glance Billing Options for AHP, Sept, 8, 2015
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Direct Billing by an NPP (Billing Option #1)
Incident to Billing Criteria (Billing Option #2)
If NPP’s not yet enrolled in Medicare, only do incident-to billing. Part B News Jan.23, 2017
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