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Incident to billing - orthopaedic practice

  1. Default Incident to billing - orthopaedic practice
    Clearnace Sale
    Good afternoon:

    We have two (2) opa-c's in our orthopaedic practice.

    These are "orthopedic physician assistants-certified."

    my question - are opa-c's (certified orthopedic physician assistants) eligible to bill incident to services to medicare and/or commercial insurances?

    I need an answer seriously and any links to back up written information on this topic asap.

    Thank you very much.

  2. #2
    Several things come into play, first state scope of practice, second credentialing, and third meeting the requirements for incident to.

    Here are a couple CMS links

    Starts on page 78.

    I have never heard of the OPA-C before but I am assuming it is basically the same thing as a PA and therefore that type of provider is eligible to bill Medicare. If it is not you would need to research and find out if they are eligible providers.

    Laura, CPC, CPMA, CEMC

  3. #3
    I've just had to search for an answer to the same question for a Texas provider. I found the below link to the Texas Chapter of Orthopaedic Physician Assistants:
    I could be wrong, but it would appear to me that they can't bill incident to. See the link, it has a section about Medicare & Medicaid reimbursement.

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