Wiki How do you bill physician assistant claims?

[micki127]

Hi,

Can anyone please tell me how they are billing physician assistant claims? Most insurance will not credential PA's and with that being said then we need to bill under a supervising physician. Question is: can a PA see new patients and bill under the supervising physician?

Any advice much appreciated.
Thank you,
Micki

 

[thomas7331]

In my experience, most payers actually do credential PAs. For the ones that do not, I would recommend you review the payer's policies and/or contact them to find out how they expect PA services to be billed and whether or not they require you to follow the Medicare 'incident to' guidelines. Since it would mean putting a different provider's name on the claim that the one who performed the service, I would not be comfortable billing any claims without having something in writing from the payer outlining exactly what circumstances that payer would consider this acceptable.

 

[micki127]

In my experience, most payers actually do credential PAs. For the ones that do not, I would recommend you review the payer's policies and/or contact them to find out how they expect PA services to be billed and whether or not they require you to follow the Medicare 'incident to' guidelines. Since it would mean putting a different provider's name on the claim that the one who performed the service, I would not be comfortable billing any claims without having something in writing from the payer outlining exactly what circumstances that payer would consider this acceptable.

Thank you for your input. I have started a spread sheet regarding which insurances require billing under a supervising physician and require SA modifier amongst other nuances.