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Physician Assistant Billing - I have a question

  1. Default Physician Assistant Billing - I have a question
    Exam Training Packages
    Hi, I have a question about coding for a physician assistant. I understand about "incident to" and Medicare or Medicare products but does incident to apply to private insurances also or is it just Medicare? I've called a couple of insurance companies and they say to bill under the supervising doctor's NPI number. Does that mean the PA can see new patients? Any help would be appreciated. Thank you.

  2. #2
    Location
    Pittsburgh,PA
    Posts
    39
    Default
    we have 4 PA's in our office and we bill the private insurance companies the same way we bill Medicare as "incident to". Whether that's so called required I don't know It's the easiest based on our billing system that way. Our PA's see new patients under the direction of the supervising MD's.

  3. #3
    Location
    Evansville Indiana
    Posts
    451
    Default Incident to
    If you are billing the PA's under the MD NPI number as "Incident to",and you are following CMS guidelines, they cannot see new patients.

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default Commercial Carriers
    Our PAs see new patients and bill under the supervising MD name/NPI for commercial carriers who have so directed us. Typically these carriers do not separately credential the PAs (or NPs). Wish they would.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  5. #5
    Location
    Columbia, MO
    Posts
    12,570
    Default
    Just be very certain you have a written policy from the carrier stating that they set aside the incident to definition of Mediciare per section 2050 of the Medicare Manual. I have had reps on the phone say to bill it under the physician only to find out that is in fact a violation of the carriers policy on incident to. As I stated in another post I contacted most of the big national commercial carriers and each of them stated that the company policy on incident to is to follow Medicare. The AMA worte an article a couple of years ago and t=stated that you should check carefully before billing under the physician and get it in writing.

    Debra A. Mitchell, MSPH, CPC-H

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