Mastering Incident-to and Split/Shared Billing: Helping You Succeed in 2026

Course Description

Navigating the complexities of healthcare billing is essential for maximizing revenue and maintaining compliance. This intermediate-level webinar, led by Dawson Ballard Jr, RHIA, CCS-P, CPC, CEMC, CEMA, AAPC Fellow, provides a comprehensive exploration of incident-to and split/shared services—two critical concepts in medical billing and coding. Attendees will gain a clear understanding of the definitions, requirements, and distinctions between incident-to and split/shared services, with a focus on the latest CMS rules and regulatory updates. The session will cover eligible providers and settings, supervision requirements, and the importance of accurate documentation, including tracking time and medical decision making (MDM).

Through real-world scenarios and practical examples, participants will learn how to determine the “substantive portion” for split/shared services and apply appropriate modifiers (FS, FT) to optimize billing. The webinar will also address common compliance mistakes, audit risks, and strategies to avoid denials, ensuring attendees are equipped to maximize reimbursement and operational efficiency. Designed for coders, billers, CDI professionals, revenue cycle specialists, and providers, this training delivers actionable insights and best practices to support compliant, effective billing in today’s evolving healthcare landscape.

Learning Outcomes:

• Define and distinguish between incident-to and split/shared services, including their unique requirements and billing implications
• Interpret the latest CMS rules and updates for incident-to and split/shared services, focusing on compliance and regulatory changes
• Identify eligible providers and settings for each billing type, such as physicians, non-physician practitioners (NPPs), and various healthcare environments
• Explain supervision requirements for incident-to billing versus split/shared services, and how these impact workflow and compliance
• Demonstrate proper documentation practices to support compliant billing, including tracking time, medical decision making (MDM), and provider roles
• Apply the concept of the “substantive portion” in split/shared services, using time or MDM to determine billing responsibility
• Recognize common compliance mistakes and audit risks and implement strategies to avoid denials and maximize reimbursement
• Utilize real-world scenarios and modifiers (FS, FT) to accurately bill incident-to and split/shared services, optimizing revenue and operational efficiency

Areas Covered in the Session:

• Clearly define “incident-to” and “split/shared services,” highlighting the differences in settings, requirements, and billing implications
• Review the latest CMS rules for both incident-to and split/shared services, including the 2024 updates on substantive portion and billing provider
• Explain which providers (physicians, NPPs) and settings (office, hospital, SNF, outpatient) qualify for each billing type
• Detail the supervision needed for incident-to billing (direct supervision in office) versus split/shared services (no direct supervision required in facility)
• Emphasize the importance of thorough documentation, including who performed each part of the service and how time or medical decision making (MDM) is tracked
• Discuss how to determine the “substantive portion” for split/shared services—either more than half of the total time or a substantive part of MDM
• Provide real-world examples and scenarios for billing incident-to and split/shared services, including use of modifiers (FS, FT)
• Identify frequent compliance mistakes, such as billing for new patients under incident-to, and strategies to avoid denials and audit risks
• Explain how billing under the physician’s NPI (incident-to) yields 100% reimbursement, while NPP billing is at 85%, and how split/shared services affect payment
• Share actionable tips for optimizing documentation, supervision, and billing processes to maximize compliant revenue and operational efficiency
• Live Q&A Session

Recommended participants:

• Physicians
• Physician Assistants
• Nurse Practitioners
• Certified Nurse Midwives
• Providers
• Medical Coders
• Medical Billers
• CDI Professionals
• Compliance Officers
• Revenue Cycle Professionals
• Revenue Cycle Staff
• Practice Managers
• Hospital Administrators

About the Presenter

Dawson Ballard Jr. is a healthcare coding expert and educator with over 20 years of experience in medical coding, auditing, and education. He specializes in CPT, ICD-10-CM, and HCPCS coding across a variety of specialties, including OBGYN, family practice, and internal medicine. Dawson has held positions such as Coding Auditor & Educator at Rush University Medical Center, Audit & Compliance Specialist at LMH Health, and Risk Adjustment Coding Auditor at Blue Cross and Blue Shield of Kansas City. He holds multiple industry credentials, including Registered Health Information Administrator (RHIA), Certified Coding Specialist – Physician Based (CCS-P), Certified Professional Coder (CPC), and Certified Professional Medical Auditor (CPMA). Dawson is recognized as an AAPC Fellow and actively contributes to professional associations, having served as a local chapter officer, speaker, and published author on medical coding topics.