Medicare’s 2012 Surgical Assist Exclusion List Now Available


by Andrew Iwanik, AAPA senior manager of reimbursement 

Medicare will not pay for an assistant at surgery on procedures that it has determined is required in fewer than 5 percent of surgical cases nationally. The payment exclusion applies to all first assistants, PAs, MDs and NPs.

An updated surgical assist exclusion list was generated with the publication of the new physician fee schedule for 2012. For each code on the exclusion list Medicare states, “statutory payment restriction for assistants at surgery applies to this procedure. Assistant at surgery may not be paid.”

The 2012 list was derived from the National Physician Fee Schedule Relative Value File, which is available on Medicare’s website.

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