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Pa billing question

  1. Default Pa billing question
    Medical Coding Books
    I'm pretty comfortable with the incident to guidelines but now our PA is billing under her own number in order to see new patients and consults - is there any restrictions I need to be aware of? And I am assuming the insurances she is not contracted with still need to follow the incident to rules or insurance specific guidelines? Thanks - Merilee

  2. #2
    We bill for serveral NP's and PA's and have not had problems with insurance companies limiting them in an office setting. We do know that some insurance companies require they be credentialed and will not allow incident to billing like Medicare does. I recommend that you check with each ins co to determine what their rules are. I have been told that with Medicare you can swap back and forth between billing under the physician and billing with the PA or NP's number. If they are performing incident to bill under the physician for higher reimbursement and only bill thru their own number when you do not meet incident to guidelines. Good Luck!

  3. #3
    The other thing to consider is what are PAs allowed to do per your state guidelines. Some states won't allow them to see new patients at all.

    Laura, CPC

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