AAPC - Back to school
Results 1 to 4 of 4

Thread: New patients and nurse practitioners/PAs

  1. #1

    Default New patients and nurse practitioners/PAs

    AAPC: Back to School
    I work for a practice that currently has 1 PA employed and will soon be employing an NP. I am questioning whether or not they can see new patients with any insurance, including Medicare. I had always been under the impression that they could not see new Medicare patients, but could with all other carriers. Now, it seems that that only applies to "incident to" and therefore, could see new patients if billing under the NP/PAs number... is this correct?

    Also, with Worker's Comp claims, is it still the case that these always need to be addressed initially by the physician and can only then be seen and billed by the NP/PA?

    Any and all help will be greatly appreciated!! I would love any supporting documentation you might be able to provide as well. Thanks so much for your help!

  2. #2
    Join Date
    Apr 2007

    Default Depends on your state

    Medicare will pay for new patients under NPPs if it is allowable in your state. They pay 85% of the physician fee schedule.

    As far as insurances go, some don't even credential NPPs, so that will be carrier specific.

    I imagine that the workers comp will be the same thing, in that it will vary state to state.

    I know that doesn't seem very helpful, maybe if you list what state or states you deal with someone will have more specific info.

    Laura, CPC

  3. #3
    Join Date
    Apr 2007
    North Carolina


    In addition to Laura's statment......

    Review Sections: (CMS Manual)

    60: "incident to"
    190-PA billing
    200-NP billing



    On the AAPA website, the left hand side addresses WC, Private payers, etc.
    Last edited by RebeccaWoodward*; 06-17-2009 at 11:41 AM.

  4. #4


    Thanks for that tip, I'm in Virginia....

Similar Threads

  1. Nurse Practitioners
    By paulaf in forum OB/GYN
    Replies: 1
    Last Post: 08-26-2013, 03:53 PM
  2. nurse practitioners
    By cward267 in forum Medicare Regulations
    Replies: 2
    Last Post: 12-28-2012, 02:44 PM
  3. Nurse Practitioners in the ED
    By mfanning in forum Emergency Department
    Replies: 1
    Last Post: 04-07-2009, 02:47 PM
  4. Nurse Practitioners
    By Candice_Fenildo in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 05-24-2007, 09:46 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.