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Thread: Question on PA Guidelines for Billing

  1. #1
    Join Date
    Apr 2007

    Default Question on PA Guidelines for Billing

    AAPC: Back to School
    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
    Join Date
    Apr 2007
    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
    Join Date
    Apr 2007


    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

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