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Navigating Medicare’s Incident-to Rules

Ronda Tews, CPC, CHC, CCS-P, Senior Director, Billing and Coding Compliance, ModMed, Nicole Pla, Senior Product Manager, ModMed

PRESENTERS

Ronda Tews, CPC, CHC, CCS-P
Senior Director, Billing and Coding Compliance, ModMed

Nicole Pla
Senior Product Manager, ModMed

This webinar was recorded on July 16, 2025.

If you’re responsible for billing or managing non-physician 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