How much is the physician reimbursed if incident-to requirements are met?

When incident-to requirements are met, the physician is reimbursed at 100%. This scenario typically arises in a practice setting where a non-physician provider (like a nurse practitioner or physician assistant) delivers the service under the supervision of a physician. For billing to qualify as "incident-to," the services must be part of an established plan of care and the physician must be personally involved in the patient's treatment.

The critical aspect of incident-to billing is that services performed by the non-physician provider are considered part of the physician's service, allowing for full reimbursement as if the physician had performed them directly. This leads to the higher reimbursement level of 100%, which incentivizes practices to effectively utilize their healthcare teams while maintaining the necessary oversight and connectivity to the physician's care.

In contrast, the other options reflect lower reimbursement rates, which do not align with the stipulations governing incident-to billing practices under Medicare guidelines. The full reimbursement helps to ensure that practices can maintain financial viability while offering comprehensive patient care.