Federal Health Laws regulate Medicare and guide reimbursement for Physician Assistant services. Depending on the practice situation, the services of the PA are reimbursable at a percentage of the physician rate by most insurance companies, workers' compensation and major federal programs. The claim is submitted at the full physician rate for payment and the National Provider Identification number (NPI) number of the Physician Assistant will notify Medicare that the reimbursement should be reduced to 85% schedule.
PA reimbursement is 85 percent of physician fee schedule/physician first assist fee schedule when the PA is:
PA reimbursement is 100 percent of physician fee schedule (use Medicare guidelines for "incident-to" services) when the PA is: