Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians – Medical Policy Article

Psychological services may be billed 'incident to' a physician's professional services only when the billing provider personally evaluates and initiates treatment and the services are performed under the physician's general supervision by specifically listed, state-licensed practitioner types acting within their authorized scope. Services delegated to unlicensed personnel, to practitioners outside the listed categories, or billed as incident-to for hospital/SNF inpatients during a Medicare-covered stay are not covered; strict documentation of initial evaluation, licensure, supervisory arrangements, and, when applicable, office-staff status in institutional settings is required.

"Psychological services may be furnished 'incident to' a physician's professional services only after the billing provider personally evaluates the patient and initiates the course of treatment; tra..."