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Incident-to services for Mental health

Duang Posted Mon 04th of March, 2019 22:57:47 PM
Does incident-to Medicare rule apply for commercial payers? Does the supervising provider have to be in the same building as the rendering/resident counselor for commercial payers??
SuperCoder Answered Tue 05th of March, 2019 03:16:09 AM


Thanks for your question.

Commercial payers may have different billing rules for incident-to guidelines and not all commercial payers follow incident-to guidelines, and some will not recognize certain NPPs.

The practice’s commercial contracts with whom you have contract with, should be clear as to whether services provided by employed non-physician practitioner can and should be billed under a supervising physician, and whether that payer follows incident-to guidelines.

As per the general rule, the supervising physician must be present in same office or suite and immediately available during the encounter to furnish assistance and direction when necessary.

Hope this helps.




Duang Posted Sun 19th of May, 2019 09:06:14 AM
Hi I have a following questions re Mental health billing and incident to service aka supervisor claims Can LPC supervise oversee by another LPC In another word can LPC use the another LPC's NPI to submit the bill to the insurance carrier If a non-license mental provider sees patient s...
SuperCoder Answered Mon 20th of May, 2019 10:39:04 AM


Thanks for your query. Our team is working on the question and will reply soon.




Duang Posted Mon 20th of May, 2019 10:51:59 AM
Great. Thanks so much!!!
SuperCoder Answered Tue 21st of May, 2019 05:28:55 AM
Hi Thanks for your patience According to Medicare Physicians medical doctors MD and doctors of osteopathy DO particularly psychiatrists Clinical psychologists CP Clinical social workers CSW Clinical nurse specialists CNS Nurse practitioners NP Physician assistants PA Certified nurse-midwives CNM and Independently Practicing Psychologists IPP are authorized by the act to...
Duang Posted Tue 21st of May, 2019 07:06:06 AM
Very helpful. Thanks so much!
SuperCoder Answered Wed 22nd of May, 2019 01:35:22 AM

Thank you, happy to help.

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