Hi Jennifer, thanks so much for the video. I am a PA practicing family medicine. Is it safe to assume incident to billing is only applicable to chronic care management and not preventative services like annual wellness checks? Also, would it be applicable to an instance when a mid level makes changes to the care plan for a diagnosis that was previously evaluated by the MD? (Ex. Changing HTN medication due to non efficacious response from initial care plan.) Or is it only applicable when care plan stays status quo without changes? Thanks again!
Hi there and thank you for asking! Wellness visits are best to be billed under the NPP performing the services. Remember incident-to is for professional services only so any in-house labs and tests (i.e ECG) that could be done during the visit would not qualify for incident-to billing. Incident-to is applicable anytime there is a care plan set forth by a doctor so even for acute needs that may need a follow up, not just chronic conditions (although that is when it would be most applicable). Making changes to medications, or adding a medication for an existing care plan/diagnosis would qualify as long as that is part of the intended reason for the follow up. I hope this helps- good luck and thank you again!
Excellent video. I have spent my entire career explaining exactly this to practices.
It is something that seems to be a little difficult for people to understand. Thank you for watching!
Hi Jennifer, thanks so much for the video. I am a PA practicing family medicine. Is it safe to assume incident to billing is only applicable to chronic care management and not preventative services like annual wellness checks?
Also, would it be applicable to an instance when a mid level makes changes to the care plan for a diagnosis that was previously evaluated by the MD? (Ex. Changing HTN medication due to non efficacious response from initial care plan.)
Or is it only applicable when care plan stays status quo without changes?
Thanks again!
Hi there and thank you for asking! Wellness visits are best to be billed under the NPP performing the services. Remember incident-to is for professional services only so any in-house labs and tests (i.e ECG) that could be done during the visit would not qualify for incident-to billing.
Incident-to is applicable anytime there is a care plan set forth by a doctor so even for acute needs that may need a follow up, not just chronic conditions (although that is when it would be most applicable). Making changes to medications, or adding a medication for an existing care plan/diagnosis would qualify as long as that is part of the intended reason for the follow up.
I hope this helps- good luck and thank you again!