Incident-To Services – Supervising Provider Billing Instructions

In the office, among other criteria, incident-to services must be rendered by a qualified provider who is directly supervised. To meet supervision requirements for incident-to, the billing provider does not have to be physically present in the treatment room while the service is being provided, but must be present in the immediate office suite, for the entire duration of the service, to render assistance if needed.

If the billing physician is a solo practitioner, he/she must directly supervise the care. In a group practice, there may be situations when the provider responsible for the treatment plan is not the provider physically present in the office suite when the patient is seen in follow up. Thus, the supervising provider can be different than the ordering provider.

At this time, the supervising physician qualifier for Item 17 of the CMS-1500 (02-12) is not required for incident-to services. In the case of a service provided incident-to, when the person who ordered the service is not supervising, enter the National Provider Identifier (NPI) of the “supervising provider” in the lower unshaded portion of Item 24J. Read more at the following link: