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Medicaid-generally get down

  1. #1
    Default Medicaid-generally get down
    Exam Training Packages
    I don't generally get down to the "final details" of payer regs ... (except for Medicare) ... but a question was addressed to me that maybe someone knows.

    Medicaid (Virginia) is telling a friend of mine that they will not pay for Physician Assistant services (pretty much just follow up visits) if Medicaid is the primary insurance.

    The PA is seperately enrolled into the Medicaid program. and this makes no sense to me - seperately enrolled, within their scope of services, what does "primary" payer have anything to do with it? I just don't follow ...

    As far as I know, our PA's are being reimbursed just fine ... so why would it be different for another practice?


  2. #2
    Milwaukee WI
    Default Postop?
    Well, this is just off the top of my head ... but you mention "follow-up" visits ... could these be part of the post-operative care?

    I'm in a pediatric practice, so Medicaid is the government payer we see most frequently ... but I'm in Wisconsin, not Virginia. Our allied health professionals are all separately credentialed with Medicare and Medicaid and their services are billed out - and paid - under their own names (unless truly incident to). But obviously, if a PA is doing the post-operative check it's coded as 99024 (even though it may have been the surgeon who performed the operation).

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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