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

In order for NPP services to be covered as incident to the services of a physician, the services must meet all of the requirements for coverage specified in the Medicare Benefit Policy Manual, Chapter 15, Sections 60 through 60.1. For example, the services must be an integral, although incidental, part of the physician’s personal professional services, and they must be performed under the physician’s direct supervision.

NPPs such as a physician assistant or a nurse practitioner may be licensed under state law to perform a specific medical procedure and may be able to perform the procedure without physician supervision and have the service separately covered and paid for by Medicare as a physician assistant’s or nurse practitioner’s service. When the NPP provides the service unsupervised, it is an NPP service and is not incident to the services of a physician. See Medicare Benefit Policy Manual, Chapter 15, Sections 190, 200 and 210.