When performing services in a nursing home, which condition must be met for "incident to" billing?

For "incident to" billing in a nursing home setting, it is crucial that both the nurse practitioner (NP) and the supervising physician are present during the delivery of care. This guideline is in place to ensure that the services rendered by the NP are considered an extension of the physician's care. "Incident to" billing allows NPs to bill for services they provide under the supervision of a physician, which is an integral aspect of compliance with Medicare guidelines.

When both the NP and physician are present, it demonstrates that the service is a collaborative effort, thus legitimizing the billing process under the "incident to" provisions. This helps ensure that patients receive comprehensive care, as the physician can provide immediate oversight and manage complex cases more effectively.

Other conditions like the patient's room situation, the need for special certification, or whether the services are elective do not influence the validity of "incident to" billing in this context. The requirement focuses on the presence of the healthcare professionals providing the care, which is fundamental for this billing method.