New Patient Visit Not “Incident-to”

Q. If a new Medicare patient comes into the office and sees the physician assistant (PA) only, can we bill Medicare for the PA’s services as “incident to” the physician?

A. No.To bill incident-to in an office-based setting, the physician must have furnished a direct, personal, professional service to initiate the course of treatment of which the PA’s service is an incidental part. If your office had never seen the patient before, no service the PA provided could have been “incident to” another service. In this case, your PA would bill Medicare under his or her own provider number.


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Last Updated On

August 17, 2021

Originally Published On

January 27, 2012

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