Understanding Medicare’s ‘Incident To’ Rules: A Practical Guide for Providers

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Course Description

Are you confident your team is billing “Incident To” services correctly or could you be at risk for denials and noncompliance?

Join us for this essential training on Incident To Billing, one of the most commonly misunderstood areas in Medicare reimbursement. This webinar is designed to clarify the requirements, eliminate confusion, and give coders, billers, providers, and compliance professionals the tools they need to bill under a supervising physician’s NPI appropriately.

We’ll break down the key CMS rules, including scope of practice, direct supervision, and when services no longer qualify as “incident to.” You’ll learn the necessary documentation components, how to differentiate between shared/ split visits, and common mistakes that lead to billing errors, audits, and lost revenue.

Whether you're in primary care, multi-specialty, or an outpatient clinic setting, this session will provide real-world examples, checklists, and coding strategies that can be implemented immediately to safeguard your organization.

Don't risk getting it wrong. Stay informed, stay compliant, and ensure your billing aligns with the latest guidelines.

Learning Objectives

• Define "Incident To" services and explain when Medicare allows billing under a supervising physician's NPI
• Identify the key CMS requirements for billing "Incident To," including scope of practice, direct supervision, and service settings
• Differentiate between “Incident To” services and split/ shared visits, and understand when each applies
• Recognize common documentation errors that lead to denials or compliance risk in “Incident To” billing
• Outline supervision levels required for “Incident To” services and how to ensure compliance in team-based care
• Apply correct coding practices for services rendered by auxiliary staff under the physician's plan of care
• Understand when services no longer qualify as “Incident To” and how to properly transition billing
• Implement documentation and workflow strategies to support compliant “Incident To” billing across provider and billing teams

Areas Covered in the Session

• Definition of “Incident To” Services, Overview of CMS guidelines and key terminology
• Medicare Requirements for “Incident To” Billing
• Eligible Providers and Settings
• Supervision Requirements Explained
• Documentation Do’s and Don’ts
• Scenarios That Disqualify “Incident To” Billing
• Common Billing Mistakes and Audit Risks
• Split/ Shared Visits vs. Incident To
• Coding & Modifier Tips for Accuracy
• Best Practices for Teams and Workflows
• Live Q&A Session

Suggested Attendees

• Healthcare Providers 
• Coders
• Billers
• Auditors
• Administrative Staff
• Hospitals and Health Systems Staff
• Physician-Based Practices
• Legal
• Practice Managers and Administrators
• Compliance Officers
• Revenue Cycle Managers
• Clinical Documentation Improvement (CDI) Specialists
• Office Managers and Front Desk Supervisors
• Claims Managers and Reimbursement Specialists
• Federally Qualified Health Centers (FQHCs)
• Rural Health Clinics (RHCs)
• Billing Companies and Consultants
• Healthcare Educators and Trainers
• Anyone Responsible for Medicare Billing Compliance

About the Presenter

Keisha Wilson, CCS, CPC, CPCO, CPMA, CRC, CPB, AAPC Approved Instructor, the founder/ CEO of KW Advanced Consulting, is a seasoned professional with over 20+ years of experience in the healthcare field. Her career in large teaching hospitals and acute ambulatory care systems includes roles such as an outpatient coding specialist, clinical documentation improvement (CDI) specialist, compliance operations coding and billing manager, interim compliance director, and consultant to various coding companies. Her extensive experience is a testament to her leadership and deep understanding of the industry.

Keisha is not just a subject matter expert in Compliance and Revenue Cycle Management but also a dedicated educator and trainer. She excels in Risk-Based Audits, Retrospective, Prospective, Evaluation and Management audits, and auditing and coding of multi specialty, documentation, and coding Telehealth/ Telemedicine services, Risk Adjustment/ HCC provider and coder education/ training and webinars. Keisha has developed and implemented numerous compliance documentation and coding training programs for organizations of all sizes. She is an approved instructor for KW Advanced Consulting and an adjunct instructor for the American Academy for Professional Coders (AAPC), teaching a wide range of compliance and coding courses.

Keisha's dedication to sharing her expertise extends beyond her professional roles. She serves on the Board of Directors for an outpatient mental health clinic and actively participates in various telehealth and compliance committees. As a published author, she regularly contributes coding articles for KW Advanced Consulting, keeping the industry updated with the latest developments. Her collaboration with the AAPC editors on various Primary Care Coding Alerts and AAPC Magazine (formerly Healthcare Business Monthly) is a testament to her commitment to advancing the field.

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Additional Information

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

Can’t Listen Live? No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience.

For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com 

This is a Live Virtual session.

A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.

Purchase Order Form - Click Here to download PO form. 

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