Got coding questions? Your Academy has the answers. Each month we feature a member’s question with an answer provided by AAPM&R’s Reimbursement and Policy Review Committee (RPRC).
Q: Can incident-to billing be used in the inpatient or skilled nursing facility setting?
A: Typically no. Incident to services are services furnished incident to physician professional services in the physician’s office. Incident to services are consider physician services; under Medicare they are billed as Part B services. Similar services provided in a SNF or inpatient setting would typically not be separately billable. For more information about how to bill for incident to services, see the Medicare Learning Network Matters article SE0441. Private payers may have different rules regarding billing of incident to services, so members are encouraged to work with their payers to determine the appropriate guidelines to follow.
Find additional resources related to reimbursement here. Do you have a coding or billing question? Contact AAPM&R at firstname.lastname@example.org for assistance.
Accurate coding is the responsibility of the provider. This article is intended only as a resource to assist in the billing process.