Wiki physician assistant billing

[RODRIGUEZL]

My surgeon will be getting a physician assistant who will also be doing surgery. Can someone out there tell me if there is a difference in reimbursement for a PA vs a physician especially for Medicare and Medi-caid

 

[Texascoder64]

Medicare allows 85% for the PA if billed under the PA's NPI#

 

[kreuschle]

What about non-Medicare? Payers do not always credential/contract with PA... can you get reimbursement for their work from commercial carriers?

 

[mitchellde]

If the payer does not credential the PA you will have to bill out of network or have the physician perform the surgery. Also you will be responsible for telling the patient the PA is out of network so the patient can decide if they want the PA as the surgeon.