Is the concept of incident-to recognized in a facility setting?

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The concept of incident-to primarily applies in a professional services context, particularly in outpatient settings where non-physician practitioners (like nurse practitioners and physician assistants) provide services under the direction of a physician. In a facility setting, such as hospitals or skilled nursing facilities, the incident-to provisions do not typically apply.

Services provided in these environments are governed by different rules and regulations, which do not allow for billing under the incident-to provision. Instead, facility services are billed according to the facility's scope of service and level of care provided rather than being attributed to the supervising physician in the same manner that applies in outpatient practice.

This clarification reinforces why incident-to is not recognized in a facility setting, making the choice that indicates its inapplicability in such environments the most accurate.

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