What must be true for a physician to actively participate in incident-to services?

Active participation in incident-to services requires that the physician take part in the treatment of the patient. This means the physician has to be involved in the patient's care for the services provided by non-physician practitioners to qualify for Medicare’s incident-to billing guidelines.

When a physician actively participates in the treatment, it establishes a direct connection and ongoing relationship between the physician and patient. This is critical because incident-to services allow non-physician practitioners, like nurse practitioners or physician assistants, to bill under the physician's National Provider Identifier (NPI) when these conditions are met. However, the physician does not have to be physically present in the same location during the entire encounter, but they should have initiated care and must oversee the treatment.

For billing to occur under the incident-to rule, it is essential that there is an initial evaluation and ongoing management of the patient by the physician, ensuring that the non-physician provider is working under the physician's direct supervision and according to the physician's plan of care. Therefore, the requirement for the physician to actively partake in the treatment is fundamental to comply with Medicare's incident-to guidelines.