Author Topic: "Incident To" billing for IOP  (Read 1231 times)


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"Incident To" billing for IOP
« on: September 09, 2020, 02:51:03 PM »

I am new to facility billing and taking over for an office who's supervisor left recently and caused confusion before they left.

We bill on a UB for IOP services with rev codes 0905 or 0906, we have services provided by PsyD, MSW/LCSW, CATC but supervised by an MD. We bill POS 22, and bill type is 131. When is it appropriate, if at all, to bill "incident to". In the past it was only billed with the supervising MD and no one knows why the switch happened to start billing "incident to", but no one even knows if we were doing it right in the beginning. So, when is it appropriate to bill incident to, if at all?


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Re: "Incident To" billing for IOP
« Reply #1 on: September 11, 2020, 09:36:05 AM »
My understanding is that incident to billing is done when the services were performed by a nonphysician practitioner and billed using the physician's NPI (as rendering).  So basedon what you are describing below I would think that the only services billed as incident to would be ones performed by a person who is not able to be credentialing independently.  I have not seen incident to billing done in IOP settings.  I always thought that the facility billed using the supervising physician's NPI in box 76.
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Nick D

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Re: "Incident To" billing for IOP
« Reply #2 on: September 11, 2020, 03:00:53 PM »
I bill for facilities and you don't need to utilize anything pertaining to "Incident To" least I don't when billing IOP.

Side note, I'd double check the POS 22 against using 57 if you're billing SA. Your TOB fits what I use also as 131.

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