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PHYSICIAN EXTENDERS - PROPER USE AND BILLING

PHYSICIAN EXTENDERS INCIDENT-TO NURSE PRACTITIONERS PHYSICIAN ASSISTANTS NON PHYSICIAN PROVIDERS

While CMS rules regarding billing for physician extenders, including Physician Assistants (PA) and Nurse Practitioners (NP) and other Non-Physician Providers (NPP), have been published and consistent for several years, it is common to find practices that do not know or follow them. The purpose of this letter is to simplify the rules to help keep practices in compliance with CMS guidelines. This letter specifically covers rules for billing for an extender that is enrolled with CMS versus not enrolled, and when it’s appropriate to bill the extender as “Incident to”.

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