Wiki New patient seen by both PA and DR

[Cassi3434]

I have a Doctor that will be working with a PA soon. My Doctor wants to know if the PA dictates the office visit and notates that the the doctor agrees with his findings if that is enough to bill under the doctors NPI? OR, does the provider also need to dictate that he saw the patient in conjunction with the PA and agrees with the findings.

Thank you!

 

[csperoni]

If the patient is not personally seen by the physician, there are only certain situations where you may still bill under the physician.

• The carrier must follow Medicare's incident-to billing guidelines. Or have their own policy that would permit this (rare).
• IF the carrier follows Medicare's incident-to, here are some of the requirements (you should carefully review ALL requirements):

1. An established patient with an established problem
2. Only applies to office services (not facility based services)
3. Physician must be on-site in the office suite and immediately available
4. ACP must be following the physician's established treatment plan

For your scenario, specifying new patient, incident-to does not apply.