tci ED Coding & Reimbursement Alert - 2014 Issue 7

Reader Question: Was There A Close Encounter Of The Face-to-Face Kind For The Physician Assistant E/M Service?

Question:  One of our physicians heard a rumor of a relaxation of the Medicare Face-to-Face rules in the ED for patients seen by a PA that reduces payment by 15percent. Is there any truth to this? Maryland Subscriber Answer: You might be mixing up two rules. A PA can see a patient independently, although under general supervision of a physician, and bill the service in their own (the PA) name. For the physician to bill the service in their own name, there has to be the face-to-face encounter documented. Remember that only applies to E/M service, not procedures...

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