Under incident-to billing for Medicare, what percentage of physician rate is the reimbursement?

Study for the Fellowship of the Higher Education Academy (FHEA) Exam. Enhance your learning with flashcards and multiple choice questions, each equipped with detailed explanations. Ace your exam preparation!

Incident-to billing allows healthcare providers to bill for services rendered by non-physicians, such as nurse practitioners or physician assistants, under the physician's National Provider Identifier (NPI). This process is designed to offer greater flexibility and efficiency in delivering care while ensuring that a supervising physician remains responsible for the treatment plan and oversight of the service provided.

When services are billed incident-to, they are reimbursed at the full physician fee schedule rate, which is why the correct answer reflects a 100% reimbursement rate. This means that the reimbursement for incident-to services is equivalent to what a physician would receive for the same service when billed directly, promoting comprehensive patient care while upholding the involvement of licensed physicians in the process.

Understanding the implications of incident-to billing is essential for financial planning in healthcare practices, particularly as it influences both the revenue stream and the types of services a healthcare facility might offer.

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