Results 1 to 3 of 3

Question on PA Guidelines for Billing

  1. #1
    Default Question on PA Guidelines for Billing
    Medical Coding Books
    Can a PA bill under a physician that is not within the same entity?
    My understanding is that a physician must be in the office accessible during the time a PA is seeing patients. Is this also correct?

  2. #2
    Columbia, MO
    Somewhat depends on your state but in general if the PA has their own number then it usually falls to the state regs as to how far away the physician is allowed to be, if you are billing under the physician number then the physician must be within the office suite area while the patient is being seen.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    I'm a little curious to the first question, when you say "entity" do you mean building/office suite or do you mean group?

    To bill incident to for CMS the PA has to be employed by the physician/group and the physician has to be in the office while the service is provided.

    If the PA is not employed by the physician/group then they can not be billed under the physician at all.

    Laura, CPC, CEMC

Similar Threads

  1. 99080 Billing Guidelines Question
    By moore509 in forum Billing/Reimbursement
    Replies: 2
    Last Post: 05-06-2013, 08:17 AM
  2. E/M question on guidelines
    By jlb102780 in forum E/M
    Replies: 3
    Last Post: 11-22-2011, 12:37 PM
  3. Question on E/M guidelines
    By Ursula in forum E/M
    Replies: 1
    Last Post: 05-26-2011, 09:21 AM
  4. E/M question about 1995 guidelines
    By HCCCoder in forum E/M
    Replies: 11
    Last Post: 08-27-2008, 11:34 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.