Navigating Medicare’s Incident-to Rules

PRESENTERS
Ronda Tews, CPC, CHC, CCS-P
Senior Director of Billing and Coding Compliance, ModMed
Nicole Pla
Senior Product Manager, ModMed
This webinar was recorded on August 19, 2025.
If you’re responsible for billing or managing nonphysician practitioners (NPPs), you’ve probably run into questions like: Can we bill this under the physician’s NPI? Are we following Medicare rules? Are we missing out on revenue? These are exactly the kinds of challenges incident-to billing was designed to address — but only if it’s done right.
Many practices either avoid incident-to billing because it’s complicated, or they use it incorrectly, risking audits or potentially forgoing revenue they’re eligible for. This webinar will help you cut through the confusion and give you a straightforward look at how to use incident-to billing correctly.
Join us as we walk you through real-world scenarios and explain policies and documentation requirements from the Centers for Medicare & Medicaid Services (CMS) and Medicare Administrative Contractors (MACs).
You will learn:
- What qualifies as incident-to billing and when it makes sense to use it
- Medicare’s core requirements (and how to meet them)
- How state laws and payer policies can impact billing decisions
- When and how to use incident-to billing for established patients
- Practical tips to reduce errors and capture eligible revenue