Use of physician extenders poses coding problems for practices

Doctors hiring physician assistants and nurse practitioners should keep in mind that billing requirements for their services may vary.

By Julie A. Jacob, AMNews staff. Feb. 26, 2001.

Many physicians are using the increasing number of nurse practitioners and physician assistants to help them increase productivity. However, their presence also may increase confusion over how to bill Medicare and commercial insurers.

The number of physician assistants in the United States, currently about 66,000, is expected to grow 48% by 2008, according to the federal Bureau of Labor Statistics. Likewise, the number of nurse practitioners, currently about 70,000, is also increasing, according to the American Academy of Nurse Practitioners.

However, if a physician chooses to employ physician extenders in his or her practice, it's important to be aware of Medicare and commercial insurer requirements for billing for services performed by physician extenders. Billing regulations for physician extender services vary from insurer to insurer. In addition, physician extender billing requirements may also vary for the same insurer depending on the type of service the physician extender performs.

The Kentucky Medical Assn. has received numerous inquiries from physicians who are confused about how to bill for services performed by physician extenders who work in their practices, said Pat Paget, the KMA's communications director.

The Texas Medical Assn. has also gotten many phone calls from doctors who are unsure of how to bill for physician extender services, said Teresa Devine, TMA's director of health care financing. In fact, the TMA received so many questions regarding billing for physician extender services that it held a series of workshops on the issue. [...]