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Thread: PA billing

  1. #1

    Default PA billing

    AAPC: Back to School
    When a PA is assisting the doctor in the office on a surgery can the PA bill too?

  2. #2
    Join Date
    Apr 2007
    Greeley, Colorado


    Only if the procedure allows for an assist...and use mod -AS.

  3. #3
    Join Date
    Apr 2007
    North Carolina


    There are surgeries that will warrant the use of an assistant...if medically necessary. The modifier will vary from state to state to indicate that it is an assistant. Our region requires modifier AS with the exception of Medicaid. They require modifier 80. There are various sources you can refer to that will indicate whether or not the service is payable for a PA. The physician must dictate the role of the PA to warrant medical necessity. Simply dictating the PA's name won't cut it.

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Teaching Hospital

    Additionally, if you are in a teaching facility, the physician must dictate that "No qualified resident was available to assist, so PA Name assisted in this procedure." AND you would use modifier -82.

    F Tessa Bartels, CPC, CPC-E/M

  5. #5
    Join Date
    Apr 2007
    Albany, NY

    Default Determining if an assistant is allowable

    This information is available through CMS (on the fee schedule), but UMD was nice to consolidate them into a user-friendly list.


    Medicare pays for an assistant where 95% of surgeons bill for an assistant. That means if less than 5% of surgeons report an assistant for a specific CPT, Medicare won't pay.

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