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Thread: Question about PAs

  1. #1
    Join Date
    Apr 2007
    Lehigh Valley

    Default Question about PAs

    AAPC: Back to School
    Hello all,

    I have a question about what medicare is stating about incident to with physicians.

    I understand that if I bill under the PA's # if there is no direct physician present; however, what if they see this new patient and they come back already an established patient? Does the physician now need to see this patient in order to bill incident to? Or do the subsequent visits all get billed under the PA only?

    My doctors have been told that they need to see new patients and participate in their treatment plan. They do make MDM on the new patients, if they are in the office; however, I still bill under the PA, which I understand. But I am not sure what to do about the subsequent visits.

    Thanks for the help!.

  2. #2
    Join Date
    Apr 2007
    Greenville, SC


    If the PA is credentialed with the particular carrier, you should bill under the PA...hence not "incident to"....

    if the PA is not credentialed with the carrier, they can only see established patients with established problems (no new patients, no new problems; the treatment plan must have already been established by the physician)....the billing physician must sign off on all documentation; the billing provider must also be readily available in the office suite (direct physician supervision). Does this help any?

  3. #3
    Join Date
    Apr 2007
    Lehigh Valley


    yes thank you.

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