Services of Non-Physician Practitioner Furnished Incident To Physician's Services

Services of such auxiliary personnel as nurses, technicians, and therapists may be covered when furnished incident to the professional services of a physician as discussed in the Medicare Benefit Policy Manual, Chapter 15, Section 60. A physician may also bill the services of certain non-physician practitioner (NPP) as services incident to a physician’s professional services. The NPP must be licensed by the states under various programs to assist or act in the place of the physician and include physician assistants, nurse practitioners, clinical nurse specialists, and certified nurse-midwives. See Medicare Benefit Policy Manual, Chapter 15, Sections 150 through 200 for coverage instructions for various allied health/NPP services.

Services performed by the NPP incident to a physician’s professional services include not only services ordinarily rendered by a physician’s office staff person (e.g., medical services such as taking blood pressures and temperatures, giving injections, and changing dressings) but also services ordinarily performed by the physician such as minor surgery, setting casts or simple fractures, reading x-rays, and other activities that involve evaluation or treatment of a patient’s condition. However, only those services that are within the individual’s scope of practice and for which the individual is qualified may be furnished