To understand PA billing, you first need to understand a basic billing concept: Medicare, and most other insurers, reimburse for services provided by PAs (and NPs) at a discounted rate. They take off 15% of the reimbursement typically paid to physicians when the same service is performed by a PA or NP. This means that PAs/NPs are often reimbursed at 85% of the physician rate.
There are two options that give PAs the opportunity to provide medical services and be eligible for reimbursement at the full 100% physician rate. They are “incident to” and split (shared) billing. Read more on Career Central.
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