Which setting is not eligible for "incident to" billing according to guidelines?

The correct answer identifies a setting that is not eligible for "incident to" billing. "Incident to" billing allows healthcare providers to bill for services provided by auxiliary personnel under the supervision of a physician or qualified healthcare professional. However, specific criteria limit where this billing can occur.

In the context of healthcare settings, hospitals typically do not qualify for "incident to" billing because the services rendered in hospitals are considered part of a broader facility fee, where the facility itself is billing for the comprehensive care provided. This contrasts with outpatient settings where the individual practitioner's services are billed separately and where “incident to” rules can apply more flexibly.

On the other hand, outpatient clinics, nursing homes, and home care services often allow for "incident to" billing when the appropriate supervising criteria are met. These settings are structured such that the services provided can be directly linked to a specific physician or qualified provider who is supervising the care being billed. Thus, services rendered there can fall under the "incident to" guidelines as long as the supervision and other requirements are adhered to, making them eligible for this type of billing.