physician assistant

  1. R

    Wiki Workers Compensation

    What is the correct way to bill PA’s and NP’s for E&M codes and Level 1 CPT codes for Workers Compensation in Masshachusetts? When billing PA’s, do we bill them as the rendering provider and have their NPI and Taxonomy code in field 24J on HCFA1500 and use modifier SA ? Will work comp accept...
  2. A

    Wiki APRN and PA Hospital Billing

    Hi there! I work at a cardiology group that currently has 12 physicians and one APRN and one PA. I was questioned by one of my physicians today on how to go about coding hospital consults and followups when the physician AND the APRN were together physically seeing each patient. How would these...
  3. E

    Wiki Help with New PA-C

    My office hired in a new grad PA-C (eff. 9/2023). Her first day with us was October 30, 2023 and we've ran into a few bumps in the road. Our biggest concern is: She is not yet credentialed with Medicare. I am not quite sure if since she is not yet credentialed with Medicare, if she's able to...
  4. P

    Wiki Can an NP or a PA bill Observation Codes for Medicare Patients?

    Hello, Can an NP ( Nurse Practitioner ) or a PA ( Physician Assistant ) bill for Hospital Observation Codes 99234-99236 for Medicare Patients? Is this allowed and paid by Medicare? Thank you.
  5. T

    Wiki PA claims submitted as Billing provider and Rendering provider for group

    Hello, We recently added a new physician assistant to our group. Our EHR was not set up correctly and has been submitting electronic claims with her NPI as billing provider AND her NPI as rendering provider. Check remittance has been received with her name on the check. It should have been...
  6. T

    Wiki Physician Assistants and Fluoroscopy-77002?

    Does anyone have any experience with billing for injections under fluoroscopy completed by a physician assistant? We use the normal injection codes such as 20610 and then bill 77002. I am struggling to find the restrictions for PA billing 77002 in Pennsylvania? Does anyone bill these services...
  7. L

    Wiki Physician Assistant Supervision Requirements - Georgia

    Hello, I seem to be finding some conflicting information regarding PA supervision requirements in the state of GA, both as it pertains to the pandemic and outside the pandemic. Can anyone please explain what the guidelines were/are for Medicare before and during the pandemic? Was/is it direct...
  8. E

    Wiki CMS-1500 Question - PA

    For Box 31 on the CMS-1500 Form, if a patient sees a Physician Assistant, does the PA's name go in that box or does it have to be an MD or DO? Any help would be great! Thank you :)
  9. KStaten

    Wiki What qualifies as a "change" in the plan of care for Outpatient Incident-To Billing Rules?

    Hello Everyone! 🙂 Soo.... Incident-to Billing can be tricky, as even references sometimes vary in their wording/ interpretation of the rules. It has been to my understanding that any time a change is made in the physician's current plan of care, it no longer qualifies as incident-to services...
  10. J

    Wiki Aetna Medicare Mid-Level E/M

    Our office is having problems with Aenta Medicare (specifically Aetna Medicare Elite and Premier) denying our Physician Assistant E/M charges stating the provider type is ineligible to bill/perform the service (PI-170). They will pay other services on the claim, if any, (like a UA, EKG, etc) but...
  11. D

    Wiki Billing a PA as an AS for Medicare

    I am trying to bill out an Assistant Surgeon - who is also a PA - to Medicare and the claims keep getting denied as either Remark Code N259: MIS/INC/INV 2ND ID or PR172: PYMT ADJ WHEN PERF BY PROV OF THIS SPECIALTY. The primary surgeon - who is an MD - was paid. Anyone have any insite on how...
  12. S

    Wiki Certified nurse practitioner vs Physician Assistant

    My private practice outpatient only internal medicine clinic needs to hire a physician extender in the Detroit Michigan area. Review of billing guidelines suggest that without physician direct supervision they both get reimbursed at 85% but a Physician assistant can see new medicare patients...
  13. D

    Wiki Physician Assistant Assist at Surgery - Different Group

    My group of general and trauma surgeons wants to "share" our PA with an orthopedic group. She would be doing first assist at surgery for both groups but only be employed by our group. My docs think I can bill the assist under our tax ID and the ortho group bill the physician services under their...
  14. E

    Wiki Can you bill 20985-AS

    Hi friends- I have a question about billing assistant surgeon. My surgeon is starting to utilize 20985 in his total joint surgeries. My question is, when billing his PA as an assistant to surgery, am I able to bill 20985- AS, or should I leave out the imaging code for the assistant since it...
  15. B

    Wiki Orthopedic Physician Assistant needed

    I am looking for an experienced orthopedic clinic PA to work 4.5 days a week seeing clinic patients, charting, injections assessing surgical candidates etc... if you know of one please tell them to send CV with salary requirements. to Thanks Bill