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Physician Assistant billing

Caralee Posted Fri 27th of July, 2012 19:46:05 PM

Not sure how to bill for a PA, the claim is sent on paper CMS-1500, which NPI is used in box 24J (the PA or physician) and who should sign in box 31

SuperCoder Answered Fri 27th of July, 2012 22:30:35 PM

A physician’s assistant (and other non-physician practitioners authorized to refer with the physician’s number) should include the provider number of the supervising physician on the referral. The billing provider should enter the provider number of the supervising physician Claims with a Non-physician Medical Practitioner (NMP) license number will not be reimbursed.

Bill specialist services with the referring PCP’s name and NPI on the CMS-1500 form in boxes 17 and 17b, if available.
• Submit claims using the supervising physician’s name in box 31, and supervising physician’s National Provider Identifier (NPI) in box 24j of the CMS-1500 form.

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