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Medicare Incident To Services Rules: Avoid Denial and Recoupment

Presenter: Leanne Foster
Duration: 60 minutes
Time: Access anytime

$199.00

Course Overview

“Incident-to” billing remains one of the most misunderstood Medicare reimbursement rules, yet it can significantly impact revenue when applied correctly. This webinar will provide a comprehensive overview of Medicare’s incident-to billing requirements, including physician involvement, established plans of care, direct supervision standards, and services eligible for reimbursement. This webinar focuses on avoiding incident to service denials and rejections. Attendees will learn how to distinguish incident-to services from shared visits and other billing arrangements while avoiding common compliance pitfalls that can trigger audits, denials, or repayment obligations.

Learning Objectives:

  • What qualifies as incident-to billing and when it makes sense to use it
  • Medicare’s incident-to billing requirements and eligibility criteria
  • How state laws and payer policies can impact billing decisions
  • When and how to use incident-to billing for established patients
  • Identify physician supervision and established treatment plan requirements
  • Recognize common documentation deficiencies and compliance risks
  • Practical tips to reduce errors and capture eligible revenue

Areas Covered in  the Session:

  • Incident to Billing/Services Overview
  • Settings Eligible for Incident to Billing
  • Incident to Billing Guidelines
  • Incident to Billing Requirements
  • Benefit Category Restrictions
  • Coverage Requirements
  • Supervision: Direct and Virtual Supervision
  • Employment Relationship
  • Plan of Care
  • Incident to Place of Services (POS)
  • Professional Services: E/M, Administration of Drugs and Biological, Minor Surgery, X-Ray, Service not billed separately
  • Office in Facility
  • Home without Practitioner
  • Home Incident to Specific Services
  • Drugs and Biologicals
  • Allergy Immunotherapy
  • RHC/FQHC/CAH
  • Incident to Documentations Requirements

Who Should Attend:

  • Physicians
  • Non-Physicians Providers
  • Medical Billers
  • Medical Coders
  • Medical Practice Administrators
  • Revenue Cycle Professionals
  • Practice Managers
  • Compliance Officer
  • Office Managers
  • Qualified Healthcare Practitioners
  • Healthcare Executives, Directors and Supervisors
  • Anyone responsible for Billing, Reimbursement and Compliance

Don’t miss this opportunity to master incident-to billing policies and documentation requirements from the Centers for Medicare & Medicaid Services (CMS) while avoiding common compliance pitfalls that can trigger audits, denials, or repayment obligation.

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