Which term describes services provided by a nurse practitioner under physician supervision billed to the physician's name?

Which term describes services provided by a nurse practitioner under physician supervision billed to the physician's name?

• A. Direct billing for service
• B. Incidence to service
• C. Capitation reimbursement
• D. Salary

Answer: (B)

This question hinges on how supervision and billing work when a nurse practitioner provides care in a physician’s practice. When an NP delivers services that are part of a physician’s established plan of care and the physician is supervising the visit, the service can be billed under the physician’s name as an “incident to” service. In this arrangement, the claim is submitted using the physician’s codes and the physician’s NPI, and reimbursement is typically at the physician rate rather than the NP’s rate, provided the payer’s rules are followed (for example, the patient is established with the physician, the service occurs in the physician’s office, and the physician is on-site to supervise). This is not direct billing for the NP’s own service, which would be billed under the NP’s own name and NPI. It’s also not capitation, which is a payer model for fixed per-member payments regardless of individual services, nor salary, which describes compensation rather than how a service is billed. So, the term that describes this billing arrangement is the incident to arrangement.

This question hinges on how supervision and billing work when a nurse practitioner provides care in a physician’s practice. When an NP delivers services that are part of a physician’s established plan of care and the physician is supervising the visit, the service can be billed under the physician’s name as an “incident to” service. In this arrangement, the claim is submitted using the physician’s codes and the physician’s NPI, and reimbursement is typically at the physician rate rather than the NP’s rate, provided the payer’s rules are followed (for example, the patient is established with the physician, the service occurs in the physician’s office, and the physician is on-site to supervise).

This is not direct billing for the NP’s own service, which would be billed under the NP’s own name and NPI. It’s also not capitation, which is a payer model for fixed per-member payments regardless of individual services, nor salary, which describes compensation rather than how a service is billed.

So, the term that describes this billing arrangement is the incident to arrangement.