Physician Billing for Shared Care and “Incident to” Services

Many physician offices are confused as to the correct way to bill these types of services and the documentation necessary to support billing. They are significantly different and billable in different settings. Incident has existed for many years whereas shared care is a more recent CMS billing opportunity. Recent CMS changes to their shared care policy have added to the confusion. Reduce the risk for audits. paybacks and possibly by billing correctly. Findings of incorrect billing on a payer audit can lead to future pre and post-payment reviews which and contribute to delays in reimbursement. This Webinar will explain the changes for 2024, and identify documentation requirements for both shared care and incident to.

Learning Objectives: -

• Define shared care services and correct use
• Define “incident to” services and correct use
• Correctly report the applicable place of service codes for both services
• Identify services that may qualify for split shared care.
• Identify professionals that may provide under incident to services policy 
• Understand the difference between supervision versus incident.
• Know the reimbursement implications when billing these services.
• Know what to look for when auditing these types of services
• Do private payers follow these rules

Areas Covered:-

• Shared care policies
• Incident to policies
• Supervision policies
• Provider eligibility
• Recent changes to shared care services
• Private payer interpretations of CMS policies 
• Reimbursement considerations 

Background:-

Shared care and Incidents are specific Medicare billing policies. CMS and the AMA made some significant changes regarding shared care for 2024. Some other payers may follow these rules also

Who will Benefit?

• Providers
• Coders
• Clinic managers
• Denial management staff
• Accounts payable staff
• Auditors