Indirect to: An option for MFT’s to treat Medicare beneficiaries

Specific to Medicare Part B only, Incident to is defined as services furnished incident to a providers (such as a Clinical Psychologist) professional services when the services are furnished as an integral, although incidental, part of the provider’s professional services in the course of diagnosis or treatment of an injury or illness and services are performed in an office, outpatient clinic, or in the patient's home.

To qualify for payment under the incident to rules, services must be part of the patient's normal course of treatment, during which a provider personally performed the initial service and remains actively involved in the ongoing course of treatment.

What’s the criteria?

  • Billing is submitted under the “on site” provider’s NPI (i.e., Clinical Psychologist) providing direct supervisory services

  • Direct supervision provider must be in the office suite

  • Immediately available to furnish assistance and direction throughout the visit

  • An established patient; services rendered must be CPT’s 90832, 90834 or 90837; the Psychologist must complete the initial assessment (CPT 90791)

  • The patient must be notified before handoff

Kyle Lott