Traditional MedicareCoverageMedium impact
Psychological Services Coverage under the Incident to Provision for Physicians and Non-physicians
Medicare/CMS - LCD·Family Medicine, Internal Medicine, Psychiatry +1 more·Local Coverage Determination
Effective date
Mar 26, 2026
We identified it
Jun 17, 2026
Summary
This Local Coverage Determination clarifies billing requirements for psychological services provided under Medicare's 'incident to' provision by both physicians and non-physician practitioners. The policy establishes specific coverage criteria and documentation requirements for psychological services billed through primary care and specialty practices.
Action Required
By March 26, 2026: Billing team must review and update procedures for psychological services billed under 'incident to' provision. Ensure proper documentation requirements are met for both physician and non-physician practitioners providing psychological services. Update billing workflows to comply with new LCD L34539 coverage criteria to prevent claim denials.