Skillacquire

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Format:	On-Demand Webinar
Presenter:	Amanda L. Waesch, ESQ.
Time:	You can access the webinar anytime
Duration:	60 minutes

Medicare physician supervision rules and requirements are complex and confusing. You must master Medicare’s complex incident-to supervision and billing rules to maximize your Physicians, NPP & Mid-level provider’s reimbursement. This webinar will explore the fundamental elements of billing for services “incident to” a physician, Non-Physician Practitioners and Mid-Level Providers. The presentation will walk through the Medicare requirements for “incident to” billing. This webinar will also explore common examples to understand the intersection of “incident to” billing with state supervision requirements. Lastly, we will discuss recent enforcement actions to failing to compliantly bill services under the Medicare “incident to” rule.

Learning Objective:

Understand the Medicare incident-to billing rules for Physicians, NPPs and Mid-level Providers
Review which services can be billed incident to a physician.
Understand whose services can be billed incident to a physician.
Understand proper documentation requirements
Review the requisite supervision necessary for incident to billing
Explore common examples faced in by providers
Review recent enforcement actions
Identify common best practices

Areas Covered in the Session

What is “Incident-To” Billing?
- Applies Only to Medicare
- Allows “physicians” to bill outpatient services provided by non-physician practitioners (“NPPs”)
Physicians
Non-Physician Practitioners (“NPPs”)
Reimbursement for “Incident-To” Services
Reimbursement Without “Incident-To” Billing
All providers must be licensed and providing services within their scope of practice
“Incident-To” Billing: The Law
42 C.F.R. § 410.26: Conditions for “Incident-To” Billing
Non-Institutional Settings
Common Issues
Designated care management services under general supervision of the physician
- G0502, G0503, G0504, G0507, CPT code 99487 and CPT code 99489
- G0500: Behavioral Health Management services
- CPT codes are for Complex Care Management
Example: Ohio Supervision Requirements
Example: Florida Supervision Requirements
Supervision Example
“Incident to” Billing: Examples
Physician Fee Schedule 2021 Updates – “Incident-To”
Medicaid and “Incident-To”
State Specific Laws
More State Law Examples
Benefits & Noncompliance
Pros & Cons
Noncompliance: OIG Concerns
Noncompliance: False Claims Act
Overpayments
Best Practices and Resources

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Suggested Attendees

Practice administrators, CEOs, COOs, CFOs
Compliance Officers
Healthcare CPAs
Revenue Cycle managers
Billers
Licensed Providers
Physicians and APPs
Office Managers
Billing Staff
Medical Auditors
Practice Managers
Auditors
Billing Companies
Clinic Owners
Chief Quality Officers
Presidents/ CEOs
Senior Internal Auditors
Directors of Compliance
Regulatory/ Risk Officers
Government Employees
General Counsel
Compliance Attorneys

About the Presenter

Amanda Waesch has experience of 18 years and operates a national healthcare practice and is licensed in both Ohio and Florida. She primarily focuses her practice on healthcare, employment law, corporate law, and healthcare litigation and advises all types of employers, in particular healthcare providers, including, hospitals and physicians, on various matters.

She also chairs the firm’s litigation team that is primarily responsible for handling all reimbursement audits and appeals for her firm’s healthcare clients and heads up BMD’s Provider Relations, Audit, Appeals, and Negotiations Unit (PRAAN) which handles all-payer audits, appeals, overpayments and payment extrapolations.

Snippet From Our Previous Session

Course Content

You can access all the webinar materials after successful payment for life-time

Webinar Link + Handouts PDF

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