What type of services are classified as 'incident-to' under Medicare?

What type of services are classified as 'incident-to' under Medicare?

• A. Services provided by independent contractors
• B. Services performed in emergency rooms
• C. Services provided under a physician's supervision
• D. Services outsourced to third-party vendors

Answer: (C)

'Incident-to' services under Medicare refer specifically to those services that are provided as part of a patient’s care and are performed in a physician's office or other outpatient setting. These services must be delivered by a qualified non-physician practitioner, such as a nurse practitioner or physician assistant, under the direct supervision of a physician. The key aspect of 'incident-to' billing is that the services must be part of a plan established by the physician and provided under their supervision to be eligible for reimbursement at full physician rates. This allows for greater flexibility in patient care while ensuring that a licensed physician is overseeing the overall treatment plan. In contrast, options such as services provided by independent contractors or services outsourced to third-party vendors do not fall under this classification due to a lack of direct supervision and integration into the physician's care plan. Similarly, while services performed in emergency rooms are crucial, they are not classified as 'incident-to' because they typically involve immediate medical emergencies rather than ongoing care under a physician’s plan.

'Incident-to' services under Medicare refer specifically to those services that are provided as part of a patient’s care and are performed in a physician's office or other outpatient setting. These services must be delivered by a qualified non-physician practitioner, such as a nurse practitioner or physician assistant, under the direct supervision of a physician.

The key aspect of 'incident-to' billing is that the services must be part of a plan established by the physician and provided under their supervision to be eligible for reimbursement at full physician rates. This allows for greater flexibility in patient care while ensuring that a licensed physician is overseeing the overall treatment plan.

In contrast, options such as services provided by independent contractors or services outsourced to third-party vendors do not fall under this classification due to a lack of direct supervision and integration into the physician's care plan. Similarly, while services performed in emergency rooms are crucial, they are not classified as 'incident-to' because they typically involve immediate medical emergencies rather than ongoing care under a physician’s plan.