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TRICARE Policy Manual 6010.60-M, April 1, 2015
Providers
Chapter 11
Section 10.1
Services Rendered By Employees Of Authorized Independent Professional Providers
Issue Date:  April 19, 1983
Authority:  32 CFR 199.6(c)(2)
Revision:  C-62, April 22, 2020
1.0  DESCRIPTION
Services commonly furnished by employees in physicians’ offices or clinics which are either rendered without charge or included in the physicians’ bills are referred to as services furnished incident to a physician’s professional services. This means that the services are furnished as an integral, although incidental, part of the physician’s personal professional services in the course of diagnosis or treatment of an injury or illness.
2.0  POLICY
Services rendered by employees (i.e., aides, technicians, attendants, etc.) of an authorized independent individual professional provider (hereafter referred to as an authorized provider) are subject to the following criteria:
2.1  The individual shall be an employee for whom the authorized provider, as employer, pays a salary, Social Security taxes, Workmen’s Compensation, etc.
2.2  The services shall be performed under the authorized provider’s direct personal supervision.
2.3  The authorized provider shall bill for the services rendered by the employees.
2.4  The services rendered shall be otherwise covered, and not of a type usually performed only by a physician or other authorized provider.
3.0  EXCLUSION
The services of a Physical Therapist Assistant (PTA) or Occupational Therapy Assistant (OTA) shall not be billed as services incident to or under the supervision of a physician or other allied health professional because physicians and other allied health professionals do not meet the qualifications for a licensed registered physical therapist or licensed registered occupational therapist. See Section 3.16 for PTAs and Section 3.17 for OTAs.
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