Reimbursement

Reimbursement Alerts:

On February 21, Change Healthcare, the largest medical billing and insurance claims processing company in the country, experienced a cyber security attack that led to the company halting the processing of many healthcare transactions. Large numbers of health professionals, medical practices and hospitals have not had claims paid since the breach. Here’s what PAs need to know.

 

AAPA works with all public and commercial third-party payers to ensure coverage for the medical and surgical services delivered by PAs. A thorough understanding of PA payment policies is essential for demonstrating PA value, maximizing the collection of appropriate reimbursement and avoiding concerns about fraud and abuse.

Also see the Payer Reimbursement Policies for PAs and a Primer on PA Reimbursement.

 

Billing statement paper with a pen and stethoscope on top

Guide to PA Regulations and Compliance thumbnail

Get the definitive guide to PA policy and compliance considerations—be equipped to advocate for yourself and the profession!
The Essential Guide to PA Reimbursement thumbnail
The Essential Guide to PA Reimbursement (PDF) provides a detailed summary and explanation of the key aspects of coverage and regulatory policies related to reimbursement for medical and surgical services delivered by PAs.

Medicare

Follow these Medicare policies and regulations to maximize revenue and avoid allegations of fraud and abuse.

Medicaid

What is Medicaid and how does it cover PA services?

Commercial Payers

Commercial payer policies are often different from Medicare’s. Get information on their requirements for PAs.

Workers’ Compensation

Learn how PAs are covered under workers’ compensation claims and at what reimbursement rate.

Resources

Transparency

Learn about the importance of transparency for the medical and surgical services PAs deliver.

PA Productivity

Measuring PA productivity is important to move the profession forward. Learn about ways to measure PA value and calculate your contribution to care.

PA Practice Resources

Explore resources and tools for PAs about PA practice, competencies, and compliance.

Reimbursement Briefs

AAPA Reimbursement Briefs cover a wide range of reimbursement topics that are important to PAs and PA practice.

QPP Overview

Find out how the QPP and MACRA programs will affect your Medicare reporting activities and reimbursement.

Communications with Federal Executive Branch

Read the latest communications from AAPA to federal agencies and find out how AAPA works to promote the profession through regulatory advocacy.

EHR Toolkit

Learn about the importance of EHR systems that are designed, selected, and implemented with functionality considerations for PAs and explore resources for PAs, employers, and EHR vendors.

PAs should continue to use “physician assistant” or “PA” as their official legal title in a professional capacity, particularly in clinical settings and with patients. AAPA is transitioning to use “physician associate” when possible and when it does not present a legal or regulatory conflict. For more information, please visit FAQs.