April 1, 2021

Question:
One of our physician assistants’ saw one of our established Medicare in the emergency room for increasing pain in the area being treated by the physician. The physician assistant made no changes to the plan of care established by the physician. Our physician assistant submitted this as an incident to service because it is an established patient to the practice. Is this correct?

Answer:
No. ‘Incident to’ services are not allowed in an emergency room or hospital setting. Submit the claim with the physician assistant as the rendering/billing provider.

*This response is based on the best information available as of 04/1/21