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Medicare still allows mid-level practitioner services to be billed under the physicians NPI and paid at the higher physician rate but only if the incident to requirements are met. the BHS billing guideS under the . The qualifier for Supervising physician is DQ. Coverage Table: Mental Health Services . endstream endobj startxref PDF FREQUENTLY ASKED QUESTIONS SUPERVISED BILLING FOR BEHAVIORAL - Vermont Note, as well, that supervision requirements apply only to the technical component (the actual test administration) of a diagnostic service. <> For example, a Licensed Clinical Social Worker may not hire a Nurse Practitioner and bill for the NPs medical services under the incident to provision, because a medical service by an NP is not integral to a social workers personal professional services, and is not regularly included in the SWs bill, and is outside of the SWs scope of service to provide medical services. I'm not understanding your response, as it appears different than your original question. 0000003820 00000 n For a better experience, please enable JavaScript in your browser before proceeding. NPs can be billed on their own, without the supervising MD. For hospital outpatient diagnostic services provided under arrangement in nonhospital locations (such as independent diagnostic testing facilities (IDTFs) and physicians offices), the supervising physician must be present in the office suite and immediately available to furnish assistance and direction throughout the procedures performance. }>GsX8vs}t[o For some services, supervision requirements depend on the training of the provider administering the service. endstream endobj 380 0 obj <. CMS guidelines specify, Documentation maintained by the billing provider must be able to demonstrate that the required physician supervision is furnished. The guidelines do not provide examples of appropriate documentation; however, for those services requiring personal supervision, the physician should document, with a comment and signature, his or her presence during the test. Provider Resource Center Click Disclaimer In one practice with 11 APPs, nine of them bill incident to and two of them work independently and bill under their own NPIs. VERDICT: Jury Convicts City of Philadelphia Employee of Billing Medicaid Providers for Work He Did Not Perform . Further clarification: Only licensed mental health clinicians may provide supervision to a non-licensed rostered mental health clinician for purposes of supervised billing and sign-off on IPCs. x]n0Bo`.E@KzEd 0000007971 00000 n In order to qualify as incident to services the following criteria must be met: The type of site you are operating in matters with respect to whether these services are allowed: Providers eligible to provide psychological services incident-to: None physician practitioners can provide certain services in the place of physician practitioners (Medicare providers), and bill under the Medicare providers NPI number. 7a Supervision standards for level 77 apply; in addition, the PT with ABPTS certification may supervise another PT but only the PT with ABPTS certification may bill.
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billing under a supervising provider