"Incident to" Billing in Healthcare: Navigating Complex Requirements and Ensuring Compliance

Recording of a 90-minute CLE webinar with Q&A

Conducted on Wednesday, July 19, 2017
Recorded event now available

This CLE webinar will provide guidance on complying with “incident to” billing requirements. The panel will discuss the requirements and advantages related to incident to billing and the potential ramifications of violations. The panel will also offer best practices for ensuring compliance and addressing allegations of improper billing.


There are many rules that need to be followed in order to bill Medicare. One of the more complicated rules governs services that are provided “incident to” a physician’s care. Despite the complex requirements, there are advantages to billing incident to. Namely, non-physician practitioners are able to provide healthcare services and bill at the supervising physician rate.

However, billing incorrectly may result in fines and penalties on top of underlying overpayments. For example, a South Carolina urgent care provider agreed to pay $1 million to resolve claims that included alleged violations of incident to billing rules. Healthcare providers and suppliers must understand the complexities of these rules to help ensure compliance.

Listen as our authoritative panel of healthcare attorneys discusses the incident to billing requirements. The panel will also examine its advantages, as well as the relevant pitfalls and confusion, and the consequences of violations. The panel will offer guidance for compliance and defending against allegations of improper billing.


  1. Requirements of billing services as “incident to”
  2. Pros and cons of incident to billing
    1. Advantages
    2. Common pitfalls
    3. Associated confusion
    4. Potential ramifications
  3. Guidance for compliance and defending against allegations of improper billing


The panel will review these and other key issues:

  • What are the requirements for incident to billing?
  • What are the best approaches for healthcare providers to ensure compliance when incident to billing?


Joan Polacheck, Partner
McDermott Will & Emery, Chicago

Ms. Polacheck advises on a variety of healthcare compliance issues, including fraud and abuse and related matters. She assists healthcare providers and drug and device companies to perform “legal audits” and to establish and implement compliance programs and related policies. She also has extensive experience in managed care contracting on behalf of healthcare providers.

Monica Wallace, Partner
McDermott Will & Emery, Chicago

Ms. Wallace focuses her practice on complex regulatory and transactional counseling to health care organizations. Her regulatory practice focuses on the Anti-Kickback and Stark laws; Medicare and Medicaid reimbursement and billing; legal assessments and compliance programs; and other general regulatory matters including licensure, survey/certification, and accreditation. Her transactional practice includes mergers, acquisitions and affiliations; divestitures; hospital/physician joint ventures; and corporate reorganization.  


CLE On-Demand - Streaming Video

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*Only available for attorneys admitted for more than two years. For OH CLE credits, only programs recorded within the current calendar year are eligible - contact the CLE department for verification.

**NH attendees must self-determine if a program is eligible for credit and self-report their attendance.

CLE On-Demand Video $297.00

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Customer Reviews

I enjoyed the programs content and the speaker's perspectives.

Brenda Laigaie

Wade Goldstein Landau & Abruzzo

The content covered was relevant and timely.

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Alvarez and Marsal

Very current topic and I appreciated the real life examples.

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Adelman Sheff & Smith

The speakers included a significant number of best practices, which are critical to application of the law.

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Very valuable information.

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Health Law Advisory Board

Lowell C. Brown


Arent Fox

Jennifer L. Evans



Ryan S. Johnson


Fredrikson & Byron

Gina M. Kastel


Faegre Baker Daniels

Karen S. Lovitch


Mintz, Levin, Cohn, Ferris, Glovsky and Popeo

David A. Manko


Proskauer Rose

John J. Miles

Senior Counsel

Baker Donelson

C. Elizabeth O'Keeffe


Wyatt, Tarrant & Combs

J. Peter Rich


McDermott Will & Emery

Donald H. Romano

Of Counsel

Foley & Lardner

Judith A. Waltz


Foley & Lardner

John R. Washlick


Buchanan Ingersoll & Rooney

Jesse A. Witten


Drinker Biddle & Reath

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