Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians

Medicare Part B covers psychological services furnished 'incident to' a physician's professional services when the billing provider personally evaluates and initiates treatment and listed qualified practitioners (clinical psychologists, clinical social workers, qualified NPs and CNSs) provide services within their state-authorized scope under direct physician supervision in the office. Services delegated to unlicensed or out-of-scope personnel, supervision by providers whose scope does not include psychological services, and services for hospital inpatients or SNF patients during a Medicare-covered stay are not covered as 'incident to'; institution-based incident-to coverage requires the auxiliary to be office staff and direct supervision.

"Psychological services are covered when furnished 'incident to' a physician's professional services as an integral, incidental part of the physician's personal professional services in the course o..."