This link will provide important information and documents for all your electronic billing needs. Please view the B2B instructions and all Trading Partner information. Related to billing and reimbursement for services to Medicaid, CSHCS, Healthy Michigan Plan, and MOMS beneficiaries. Coordination of benefits, casualty, manual, and related links. Medicare allows for the billing of "incident to" services performed by ancillary personnel under the supervision of a qualified Medicare provider. Services furnished "incident to" a psychologist's services are covered by Medicare if they meet specified requirements outlined in the Medicare Carriers Manual. to billing guidelines. Incident to is defined as: A physician's professional services or supplies that are furnished as an integral, although incidental, part of the physician's personal professional services in the course of diagnosis or treatment of an injury or illness. Incident to billing is only applicable to Medicare. The advantage of incident-to billing is that the practice is reimbursed 100% of the Medicare Physician Fee Schedule (MPFS) allowable. If the NPP bills directly to Medicare, with his/her name and NPI on the claim form, then the payment is reduced to 85% of the MPFS allowable—a 15% reduction). Transmittal 3950 Date: January 12, 2018 Change Request 10416. SUBJECT: 2018 Durable Medical Equipment Prosthetics, Orthotics, and Supplies Healthcare Common Procedure Coding System (HCPCS) Code Jurisdiction List. I. SUMMARY OF CHANGES: A spreadsheet containing an updated list of the HCPCS codes for Durable R 6/20.5.2/Coverage of Outpatient Therapeutic Services Incident to a Physician's Service Furnished on January 1, 2010 through December 31, 2019 N 6/20.5.3/Coverage of Outpatient Therapeutic Services Incident to a Physician's Service Furnished on or After January 1, 2020 Changes to Supervision - Requirements 60.1 - Incident To Physician's Professional Services (Rev. 1, 10-01-03) B3-2050.1 To be covered, supplies including drugs and biologicals must represent an expense to the physician or legal entity billing for the services or supplies. For example, where a patient purchases a drug and the In an office/clinic, shared/split visits must meet all incident-to requirements. Split/shared services should be billed when both the NPP and the physician provided services at the visit. To meetincident-to requirements, the NPP can see only existing patients with an established plan of care by a credentialed physician. services, the patient's financial liability for the incident to services or supplies is to the physician or other legal entity billing and receiving payment for the services or supplies. Therefore, the incident to services or supplies must represent an expense incurred by the physician or legal entity billing for the services or supplies. 27 RA "incident to" the physician's service occurs when it is a part of the physician's overall care provided for the patient. Follow up physician services are also necessary. Medicare does not permit PFS billing under the "incident to" rules in the hospital setting. This providing ongoing care as "incident to" can be billed at the APRN payment rate (85% of the MPFS) or physician payment rate (100%) if the service meets all Medicare requirements. Billing Incident to Physician Services When NPP and auxiliary personnel services qualify as "incident to" physician services, the This means