Wednesday, June 11, 2008

CMS Rescinds "Incident To" Policy that was to go into effect June 2, 2008

CMS has rescinded Transmittal 87, CR 5288, which contained some extremely stringent requirements/clarifications to Medicare's "Incident to" policy. Key points included:

A practice or clinic must be physician owned and operated in order to bill Medicare for incident to services;

A requirement for very explicit and extensive documentation within the patient's medical record as it relates to the credentials of the treating personnel;

A patient care plan which contains details as to which services will be provided by a physician versus other healthcare provider, such as a nurse practitioner or physician assistant; and,

An actual authorization in the patient chart for services provided incident to the physician/NPP initial service.

To view the actual CMS document wherein Transmittal 87 is rescinded, visit http://www.cms.hhs.gov/Transmittals/downloads/R87BP.pdf.

You may view the original Change Request (CR) 5288 at http://www.cms.hhs.gov/ContractorLearningResources/downloads/JA5288.pdf on the CMS website.

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