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Incident to billing

historically, in the office based setting, mid-level provider (Nurse Practitioner and Physician Assistant) reimbursement has been for services that are “incident to” a physician’s service. This is most often referred to as billing (Medicare Part B) for “incident to” services. As long as certain criteria are met, the mid-level provider services may be billed by the employer as if the physician had performed them at 100 percent (100 %) of the physician fee schedule. Fraud commonly occurs where services are rendered but the physician is not even on the premises.

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