Wiki PA billing

rnewsome

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Would greatly appreciate clarification on what is the correct way to bill for our PA. The PA and physician are both employed by the hospital and are seeing patients in a clinic setting. Since the PA does not have his provider identifiers yet, the billers were instructed to bill all the PA claims using the physican billing (billing/rendering/supervising) information only, and to use modifier SA on those claims to show that the patient was seen by the PA only. This does not sound right to me since the physician never actually saw the patient. Please help.

Desperate for clarification.
 
This is incident to billing which means the provider must have previously examined this patient for this same dx , and have a written plan of care in the chart note that the PA is following, and the provider you are using the NPI of must be in the office suite area while the patient is being seen by the PA. If all of these conditions are not met then you must use the PA NPI.
 
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