Incident-To and Shared Billing Guidelines for Clinicians

Insights on Billing and Documentation Requirements of Advance Practice Providers (APPs)

Medicare has changed the way providers bill for services provided by nurse practitioners and physician assistants. For providers – physicians, nurse practitioners and physician assistants, along with administration and billing staff – it is important to re-evaluate how patients are scheduled, how charges are captured, and how claims are generated in order to bill correctly and achieve optimum reimbursement.

Unfortunately for many practices, there is still much confusion and misunderstanding about billing for the services of advanced practice providers (APPs), also known as clinicians. Incident-to is a broad billing concept that applies not just to services performed by nurse practitioners and physician assistants but also to any service billed under the physician's supervision.

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