What billing method is used for outpatient services provided by a non-physician practitioner?

Prepare for the AMCA Medical Coder and Biller Certification exam. Engage with flashcards and multiple choice questions, each crafted with hints and detailed explanations. Ensure your success!

Incident to billing is the correct method for outpatient services provided by a non-physician practitioner when those services are considered part of the physician's overall care plan. This billing method allows non-physician practitioners, such as nurse practitioners or physician assistants, to bill for services under the supervising physician's National Provider Identifier (NPI) number.

For incident to billing to be applicable, the non-physician practitioner's services must be provided as an extension of the physician's care, and the physician must see the patient and establish a treatment plan before the non-physician practitioner provides services. This method allows for a higher reimbursement rate than if the non-physician practitioner billed separately, so it is beneficial for both the practitioner and the practice, assuming that all necessary criteria are met.

The other methods pertain to different billing practices that are not specifically applicable in this context. Global billing typically involves a bundling of services related to specific procedures or surgeries, while professional billing relates to services performed by the physician themselves. Fee-for-service billing is a general payment model that pays practitioners based on the specific services rendered, and it does not specifically pertain to outpatient services provided by non-physician practitioners in the manner that incident to billing does.

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