Which of the following statements about incident-to billing is correct?

Which of the following statements about incident-to billing is correct?

• A. Only NPPs can bill for services
• B. The physician must start the care
• C. Billing can occur regardless of group entity affiliation
• D. A physician can bill alone without NPP support

Answer: (B)

The statement that the physician must start the care is correct in the context of incident-to billing. This billing practice allows non-physician practitioners (NPPs) such as nurse practitioners and physician assistants to provide services under the direct supervision of a physician. However, for these services to be billed as incident-to the physician's services, the initial visit or course of care must be initiated by the physician. This requirement ensures that the physician remains involved in the patient's care and establishes a clear path of responsibility and accountability. By having the physician start the care, it helps to ensure that the treatment plan and subsequent follow-up by the NPP are consistent with the physician's guidance, thereby maintaining the quality and continuity of care. If the NPP were to initiate care independently, it would not qualify for incident-to billing, as the services would not be considered integral to the physician's established plan of care.

The statement that the physician must start the care is correct in the context of incident-to billing. This billing practice allows non-physician practitioners (NPPs) such as nurse practitioners and physician assistants to provide services under the direct supervision of a physician. However, for these services to be billed as incident-to the physician's services, the initial visit or course of care must be initiated by the physician. This requirement ensures that the physician remains involved in the patient's care and establishes a clear path of responsibility and accountability.

By having the physician start the care, it helps to ensure that the treatment plan and subsequent follow-up by the NPP are consistent with the physician's guidance, thereby maintaining the quality and continuity of care. If the NPP were to initiate care independently, it would not qualify for incident-to billing, as the services would not be considered integral to the physician's established plan of care.