What does the term "incident to" refer to in Medicare billing?

The term "incident to" in Medicare billing specifically refers to the practice of billing for services provided by ancillary personnel, such as nurse practitioners or physician assistants, under a physician's Medicare number. This billing methodology allows healthcare providers to ensure that services rendered by auxiliary staff are reimbursed at a higher rate than if billed under the ancillary personnel's provider number. For the services to qualify for this type of billing, they generally must be:

1. Provided in a setting where the physician is present and supervising, although not necessarily in the same room.

2. Necessary for the ongoing treatment of a condition.

3. Provided by personnel who are employed by the physician or have been contracted by the physician.

Thus, "incident to" billing is particularly significant because it enhances the ability of healthcare practices to maximize their reimbursement while adhering to Medicare regulations.