Effective 11/1/2011 Anthem will require all MDs and NPPs who have been assigned their own NPI to bill for their services under their own NPI. Separately reportable ‘Incident to’ services are only eligible for reimbursement under the supervising provider’s NPI if the specific type of NPP who rendered the services is ineligible to submit claims directly to Anthem. This rule even applies when a provider is in the process of applying for an NPI. If the provider is a type who is eligible to receive an NPI and is eligible to submit claims directly to Anthem, then while the provider is waiting to receive an NPI, his/her services are not eligible for reimbursement as ‘Incident to’ services.
Submitted by YSM Web Group on July 19, 2012