If they want to bill as "incident to" then they must meet the "incident to" requirements. I found this regarding billing for NPs:
"The “incident to” dilemma
By law, Medicare also covers services and supplies furnished as “incident to a physician's professional service, of kinds which are commonly furnished in physicians' offices and are commonly either rendered without charge or included in the physicians' bills.” To be billed as “incident to,” the services of nonphysicians, such as NPs, must meet four criteria:
The services must be performed under a physician's “direct supervision”;
The services must be performed by employees (including leased employees) of the supervising physician, the physician's group or the physician's employer;
The physician must initiate the course of treatment of which the NP's services are a part;
The physician must perform subsequent services of sufficient frequency to reflect the physician's continuing active participation in managing the course of treatment.
The BBA didn't change the “incident to” rules related to NP services. This means an NP can still provide, and a practice can still be paid for, services incident to those of a physician. The benefit of billing “incident to” is that the payment is the same as if the physician had performed the service — 100 percent of the fee-schedule amount.
However, one of the disadvantages of billing for “incident to” services is that more supervision is required. Because these services require direct supervision, the physician must be in the office suite when the service is rendered and immediately available to provide direction. Reimbursements for NP services billed separately don't require a physician's presence."
https://www.aafp.org/fpm/1998/0500/p12.html So the question is - do the services meet the "incident to" criteria?
