Results 1 to 2 of 2

Pa in hospital billing

  1. #1
    Default Pa in hospital billing
    Medical Coding Books
    I have a question that I can not find the answer to. Can a private speciality practice PA bill for a hospital consult? Are there rules with this billing, e.g. physician must sign off, physician must be in room, etc.? We are a private practice and have our PA's on call during the weekend. Any tips or information would be extremely helpful. Thank you

  2. #2
    North Carolina
    A PA may bill using their own provider number. Chapter 12 section 30.6.10... Chapter 15 also elaborates on the requirements for a PA to perform services. Unless state law requires, the MD is not required to sign off on the PA's chart. Also, keep in mind that "incident to" does not apply to consults. If it is within the PA's scope of practice, he/she would submit the claim under his/her NPI number.

    Specifically, a consultation service is distinguished from other evaluation and management (E/M) visits because it is provided by a physician or qualified nonphysician practitioner (NPP) whose opinion or advice regarding evaluation and/or management of a specific problem is requested by another physician or other appropriate source. The qualified NPP may perform consultation services within the scope of practice and licensure requirements for NPPs in the State in which he/she practices. Applicable collaboration and general supervision rules apply as well as billing rules;

    Physician Supervision

    The PA’s physician supervisor (or a physician designated by the supervising physician or employer as provided under State law or regulations) is primarily responsible for the overall direction and management of the PA’s professional activities and for assuring that the services provided are medically appropriate for the patient. The physician supervisor (or physician designee) need not be physically present with the PA when a service is being furnished to a patient and may be contacted by telephone, if necessary, unless State law or regulations require otherwise.

    Section 190
    Last edited by RebeccaWoodward*; 06-24-2009 at 06:55 AM.
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

Similar Threads

  1. Replies: 3
    Last Post: 07-09-2015, 06:40 AM
  2. Hospital Billing
    By MollyBK62 in forum Behavioral Health
    Replies: 1
    Last Post: 08-27-2012, 09:37 AM
  3. Hospital Billing
    By JCampbell in forum E/M
    Replies: 0
    Last Post: 08-26-2010, 09:10 AM
  4. Hospital Billing vs Physician Billing
    By CBC in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 05-19-2009, 02:14 PM

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.