Hi, I have a question about coding for a physician assistant. I understand about "incident to" and Medicare or Medicare products but does incident to apply to private insurances also or is it just Medicare? I've called a couple of insurance companies and they say to bill under the supervising doctor's NPI number. Does that mean the PA can see new patients? Any help would be appreciated. Thank you.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki Physician Assistant Billing - I have a question
- Thread starter NFBarner
- Start date
mshafr
Guest
we have 4 PA's in our office and we bill the private insurance companies the same way we bill Medicare as "incident to". Whether that's so called required I don't know It's the easiest based on our billing system that way. Our PA's see new patients under the direction of the supervising MD's.
cheermom68
Expert
Incident to
If you are billing the PA's under the MD NPI number as "Incident to",and you are following CMS guidelines, they cannot see new patients.
If you are billing the PA's under the MD NPI number as "Incident to",and you are following CMS guidelines, they cannot see new patients.
FTessaBartels
Guest
Commercial Carriers
Our PAs see new patients and bill under the supervising MD name/NPI for commercial carriers who have so directed us. Typically these carriers do not separately credential the PAs (or NPs). Wish they would.
Hope that helps.
F Tessa Bartels, CPC, CEMC
Our PAs see new patients and bill under the supervising MD name/NPI for commercial carriers who have so directed us. Typically these carriers do not separately credential the PAs (or NPs). Wish they would.
Hope that helps.
F Tessa Bartels, CPC, CEMC
mitchellde
True Blue
Just be very certain you have a written policy from the carrier stating that they set aside the incident to definition of Mediciare per section 2050 of the Medicare Manual. I have had reps on the phone say to bill it under the physician only to find out that is in fact a violation of the carriers policy on incident to. As I stated in another post I contacted most of the big national commercial carriers and each of them stated that the company policy on incident to is to follow Medicare. The AMA worte an article a couple of years ago and t=stated that you should check carefully before billing under the physician and get it in writing.