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Part B News readers know that billing NPP services comes with its own set of complications, depending upon whether the services are billed directly or under incident-to billing rules.Your private payers have their own rules for NPP billing, which may confuse some of the terms used by Medicare. Huey cited Blue Cross/Blue Shield of Alabama, which defines incident-to differently than Medicare. For example, to bill incident-to, BCBS of Alabama requires the physician to see the patient on the date of service, unlike Medicare.
 
The payer will allow certain services to be billed directly by the NPP at 70% to 80% of the fee schedule, which is the only option available when the face-to-face visit with the physician does not occur on the date of service.
 
Check with the payers in your state to have a clear understanding of the terminology.