Wiki Billing Medicare- under a PAC

[pattymhuber]

I often get confused when billing medicare. The doctor in my practice is usually the only one who sees all medicare patients, but there are times when appointments are limited and was wondering, if the patient is having to come in for a different problem, can this patient be seen by the PA instead of the Dr.? Is there any problem billing under the PA with Medicare?

Thank you!

 

[thomas7331]

As long as the PA is credentialed/enrolled with the Medicare payer, then he or she can see the patients and bill under the PA's own credentials and there should be no problem with this. The reimbursement by Medicare for a PA is reduced 15% below that which would be paid for a physician. Alternatively, if all of the 'incident to' requirements have been met for that visit, the service may be billed under the physician's credentials, although that would likely not be the case if the PA is seeing the patient for a different problem as you've mentioned.