# PA billing please help



## poyersaug (May 7, 2009)

How much face to face time does a physician have to spend with a patient, in a hospital setting, for a PA to bill under the physcians NPI.  The PA will do all the f/u work and the H&P.  

Also, if a patient is intubated and on pressors with multiple system failures, but stable on settings, could a critical care code be used.


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## BFAITHFUL (May 7, 2009)

I just read an article from the academy of physician's assistant where it states that this is considered "incidental to" services which does not apply in a hospital setting , these guidelines only apply to office settings.  I've also read this in the CMS guidelines


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## BFAITHFUL (May 7, 2009)

so therefore PA must bill under her own NPI


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## RebeccaWoodward* (May 8, 2009)

Careful........

If a hosptial encounter is shared between a physician and a NPP and the *physician provides any face-to-face substantive portion of the E/M encounter with the patient*, both the NPP and physician should each document what each personally performed. The total documentation by both the NPP and the physician should support the level of service reported..  You could report the service under the physician.

Split/Shared visists are not applicable to consultations, procedures and critical care services.

http://www.cms.hhs.gov/transmittals/Downloads/R178CP.pdf


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## aguelfi (May 8, 2009)

I've also had one insurance co. tell me to bill under the physician if the PA doesn't have their own provider # for that company.  I think it was Aetna.


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