Navigating CMS 'Incident To' Services Updated Billing & Documentation Requirements For Providers

Webinar Background, Agenda & Trainer Profile :

Incorrect reporting of incident to services has put a lot of providers at risk for fraud investigations or other recoupments leading to heavy fines and penalties last year. There is significant disagreement over the Medicare rules for these services at every provider setting. Providers should be aware of the latest 2023 billing issues surrounding the correct reporting of services provided by mid-level providers, whether independent or in conjunction with a physician. You have to be crystal clear on your shared/split visit concept, which is where a lot of deserved reimbursement is still missed. It is important for those involved in the provision of 'incident-to' services to understand the unique documentation, billing and compliance requirements for these services.

The following agenda will be discussed in detail during this session : 

• 2023 "Incident To" vs Shared/Split Visit Regulations to follow
• Assessment of each element of incident-to billing to ensure compliance in 2023
• Incident-to billing vs Shared or Split visits : Billing & Documentation Standards to meet
• Identifying when services of mid-level practitioners satisfy the incident-to billing rule
• Involvement of NPP and Mid Level Providers with New Patients and Consultation visits
• Errors to avoid when billing for "Incident-to "services performed by Non-Physician Providers
• "Incident-to" scenarios and examples
• Provider Documentation Guidelines & Requirements by CMS
• Key Differences between NPP and PA
• Preventing non-compliance through documentation and other practical tips.
• Distinguish between facility and non-facility incident-to billing.
• Scope of Practice – What does it mean and compliance importance.
• Best practices and expectations in the near future
• FAQs & Resources  

About The Trainer: Paul W. Kim has over 24 years of health law experience with a uniquely comprehensive understanding of the U.S. healthcare industry. As a former CMS employee, Paul advises clients in all aspects of health law from corporate compliance counseling to reimbursement litigation. He clerked at the Maryland State administrative hearings office, writing decisions for Administrative Law Judges. He worked in the general counsel's office of a national managed care organization and for the Maryland State Medicaid Agency at the Department of Health & Mental Hygiene. Then, prior to entering private practice, he drafted regulations and policies for the Medicare Program at the Centers for Medicare and Medicaid Services ("CMS") of the U.S. Department of Health & Human Services ("DHHS”). Having worked on reimbursement, fraud and abuse, privacy and clinical research issues from the patient, provider, payer and government perspectives, Paul has a unique understanding of the health care industry and an in-depth knowledge of the issues and challenges today clients face.