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Thread: mid level provider ?

  1. #1
    Join Date
    Apr 2007
    Posts
    17

    Default mid level provider ?

    Promo: Code Books
    Can a nurse practitioner see new patients.

    Can a physician assistant see new patients.

    Practices location Ohio.

  2. #2
    Join Date
    Apr 2007
    Location
    Columbia, MO
    Posts
    12,168

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    Yes on nurse practiioner but only under his/her own NPI number, maybe for the PA depends on the state but if so then again only under their own NPI

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Join Date
    Apr 2007
    Location
    Mission Hills, Ca
    Posts
    4

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    An NP can see his her own patients and even have his her own practice. A PA must have a supervisor. Its tricky though with NPs because Medicare won't give them their own PTAN unless thay are certified with the AANP.

  4. #4

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    Per the Medicare Benefit Policy Manual, Chap 15, Sec 60: "(Physician assistants, nurse practitioners, clinical nurse specialists, certified nurse midwives, clinical psychologists, clinical social workers, physical therapists and occupational therapists all have their own benefit categories and may provide services without direct physician supervision and bill directly for these services. When their services are provided as auxiliary personnel (see under direct physician supervision, they may be covered as incident to services, in which case the incident to requirements would apply."

    This Chapter has a lot of good information that may help answer your question.

    Does anyone know if a Registered Dietitan or Genetic Counselor would be able to see patients Incident To a physicians service?

    Thanks.

  5. #5
    Join Date
    Apr 2007
    Location
    Maryville
    Posts
    18

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    what if its not a medicare patient but a private pay pt. Do we try and follow the guideline sof the individual plans? And then how does a billing keep that all straight example This ins. may not want it under the MP or midwife but another ins may want it. Some may say incident to either way???? It can be very confusing.

  6. #6

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    It is very confusing, we sent an email or called all of our main carriers and asked them how to bill for the PA's for surgeries and office visits and what modifiers to use, then we typed up a list. An email or fax from each insurance company is best so that you have proof in writing as to how to bill for a PA. In Pennsylvania, PA's can see the new patient and follow ups but you can not bill for incident to until the supervising physician sees the patient and establishes a plan of care. I would suggest making yourself a little cheat sheet.

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