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Incident to billing in a skilled nursing facility

Alinda Posted Thu 05th of June, 2014 13:42:08 PM

THERE IS SOME CONFUSION ABOUT THE NP BEING ALLOWED TO BILL INCIDENT TO THE PHYSICIAN IN THE SKILLED NURSING FACILITY. THE PHYSICIAN IS IN THE FACILITY BUT THERE IS NO SEPERATE DEDICATED OFFICE SPACE FOR THE PHYSICIAN SERVICES.
WE HAVE FOUND A MED LEARN ARTICLE FROM 4/9 2013 THAT SEEMS TO INDICATE THE NP MUST BILL UNDER THEIR OWN NPI IN THE SNF.
THE LASTEST INFORMATION ON SUPERCODER IS 2006, SEEMS TO BE GIVING THE OK FOR NP TO BILL INCIDENT TO THE PHYSICIAN IN THE SNF.
pLEASE CLEARIFY THIS FOR OUR OFFICE.( MLN MATTERS NUMBER :SE0441
THANK YOU
ALINDA

SuperCoder Answered Fri 06th of June, 2014 08:46:51 AM

You are correct. I have read several articles including the SE0441 Med learn matters article. All of them are coming to the same conclusion that you are not able to bill “incident to” in the skilled nursing facility setting. You are stating that although the provider is in the facility and is supervising the NP, one of the requirements for billing “incident to” in the SNF setting is that there must be a separately identifiable office located inside of the SNF where the billing provider must be located. Even though all other clinical requirements have been met this one requirement is not being met. Please provide me your email for the required article.

Thanks,

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