Incident to services can be useful; however, the guidelines for incident to services can be very confusing. Explain how the guidelines for incident to services and shared/split visit are different from an E/M service performed by a physician

Question

What will be an ideal response?

Answer 1

1. The term incident to is a billing phrase used by CMS to help identify, report, and appropriately bill incidental clinical, medical, or professional services performed by an NPP when those provided services are integral, although incidental, to the physician's overall care of the patient.
2. In such a case, the physician has initiated the course of treatment for the patient, and the service provided by the NPP plays a minor part in the physician's ongoing management of the patient's care.
3. A shared/split visit identifies an E/M service visit during which an NPP and a physician have both participated in the performance of the service and the incident-to requirements have been met. CMS maintains and updates extensive guidelines regarding the identification and reporting of incident-to services and shared/split visits.