If a new Medicare patient comes into the office and sees the physician assistant (PA) only, can we bill Medicare for the PA’s services as “incident to” the physician?
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Feb 2, 2012
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Are we still scratching our heads as to why mid-levels are knocking at the State door to request an elevation of their scope of practice? What seems to be lost in the conversation or alleged debate is the obvious notion of why. Why are mid-levels seeking expanded scope of practice. Could it be because they are already performing the very services in a limited supervised manner? A low level research of the TMB website can provide insight to the fact that many physicians supervise the maximum allowable mid-level providers AND also own multiple locations. Some low level math may help here. Doctor 1 owns 3 satellite clinics plus his very own busy clinic. Doctor 1 is at his office from 8 a.m. to 6 p.m. PA1 comes in at 3:00 p.m. and stays until 10:00 p.m. to run the night clinic. At locations 1, 2, and 3, SOLE PA 2, 3, 4 are operating from 8a - 8p ALONE. Since they operate as "no appointment necessary" clinics it is quite probable that a healthy percentage of patients are new and have Medicare. Now which is the most likely scenario. A) Doctor 1 sees ALL new patients at ALL 3 sites regardless of the hour or B) Doctor 1 sees ALL new patients at ALL 3 sites regardless of the hour. The answer is YES -- wink. (sidenote: A & B are the same answer).
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