What is Incident-to Billing?

Incident-to billing is a Medicare billing practice that allows services provided by non-physician practitioners (like nurse practitioners or physician assistants) to be billed under a supervising physician's provider number at the higher physician rate. This requires direct physician supervision, established treatment plans, and specific documentation requirements to qualify for the enhanced reimbursement.

Why incident-to billing matters

• Affects reimbursement rates: Allows higher payment for non-physician services
• Requires specific conditions: Must meet supervision and documentation requirements
• Impacts practice operations: Influences staffing and workflow decisions

How Solace can help

A Solace advocate can help you understand when incident-to billing applies to your care, ensure services are billed appropriately, and address any confusion about which provider delivered your services. Advocates can also assist with questions about billing practices and provider supervision.