Incident To vs Split Shared Services Explained for Stronger 2026 Billing

Navigating the complexities of healthcare billing is essential for maximizing revenue and maintaining compliance. This intermediate-level webinar, led by Dawson Ballard Jr, RHIA, CCS-P, CPC, CEMC, CEMA, AAPC Fellow, provides a comprehensive exploration of incident-to and split/shared services—two critical concepts in medical billing and coding. Attendees will gain a clear understanding of the definitions, requirements, and distinctions between incident-to and split/shared services, with a focus on the latest CMS rules and regulatory updates. The session will cover eligible providers and settings, supervision requirements, and the importance of accurate documentation, including tracking time and medical decision making (MDM).

Through real-world scenarios and practical examples, participants will learn how to determine the “substantive portion” for split/shared services and apply appropriate modifiers (FS, FT) to optimize billing. The webinar will also address common compliance mistakes, audit risks, and strategies to avoid denials, ensuring attendees are equipped to maximize reimbursement and operational efficiency. Designed for coders, billers, CDI professionals, revenue cycle specialists, and providers, this training delivers actionable insights and best practices to support compliant, effective billing in today’s evolving healthcare landscape

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• Introduction to Incident-To Billing
  • CMS Definition
  • Source of CMS Guidance
  • The Basics of Incident-To Billing
• Documentation Requirements for Incident-To Services
  • Documentation Standards
  • Supervision Requirements
  • Eligible Providers and Practice Settings
• Incident-To Clinical Scenarios
  • Real-World Case Examples
  • Common Billing Challenges
  • Compliance Considerations
• Understanding Split/Shared E/M Services
  • CMS Definition and Requirements
  • When Split/Shared Services Apply
  • Key Regulatory Updates
• Determining the Correct Billing Provider
  • Code Determination Methods
    • Total Time on the Date of Service
    • Substantive Portion of Medical Decision Making (MDM)
  • Substantive Portion for Critical Care Services
  • Additional CMS Guidance
• Documentation and Modifier Requirements
  • Documentation Best Practices
  • Attestation Statements
  • Appropriate Use of Modifier FS
  • Appropriate Use of Modifier FT
  • Time Tracking and MDM Documentation
• Split/Shared Service Scenario #1
  • Visit Note Documented by the Non-Physician Provider
  • Which Provider Should Bill the Service?
    • The Case for the Physician
    • The Case for the Non-Physician Provider
    • The Verdict
    • Supporting Rationale
• Split/Shared Service Scenario #2
  • Physician Documentation Review
  • Which Provider Should Bill the Service?
    • The Case for the Physician
    • The Case for the Non-Physician Provider
    • The Verdict
    • Supporting Rationale
• Compliance, Audit Risks, and Reimbursement Strategies
  • Common Compliance Mistakes
  • Audit Risks
  • Preventing Claim Denials
  • Maximizing Reimbursement
  • Best Practices for Operational Efficiency
• Live Q&A Session

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Dawson Ballard Jr, RHIA, CCS-P, CPC, CPMA, AAPC Fellow, is a healthcare coding expert and educator with over 20+ years of experience in medical coding, auditing, and education. He specializes in CPT, ICD-10-CM, and HCPCS coding across a variety of specialties, including OBGYN, family practice, and internal medicine. Dawson has held positions such as Coding Auditor & Educator at Rush University Medical Center, Audit & Compliance Specialist at LMH Health, and Risk Adjustment Coding Auditor at Blue Cross and Blue Shield of Kansas City.

He holds multiple industry credentials, including Registered Health Information Administrator (RHIA), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), and Certified Professional Medical Auditor (CPMA). Dawson is recognized as an AAPC Fellow and actively contributes to professional associations, having served as a local chapter officer, speaker, and published author on medical coding topics.

Additional Information

Snippets From Our Previous Session