Medicare_Carriers_Manual / 2156 / 2156

Why This Topic Matters

Understanding this guidance helps organizations determine whether physician assistant services fall within Medicare coverage rules and how those services fit into broader billing and supervision requirements.

Article Sections

1. Ed. Note: For further information see:

   A brief editorial note pointing to related manual material.

2. 2156. PHYSICIAN ASSISTANT SERVICES

   Overview of Medicare policy for physician assistant services, including eligibility, coverage framework, and payment context.

3. A. Qualifications for PAs

   Basic qualification standards for physician assistants participating under Medicare.

4. B. Covered Services

   General coverage framework for services furnished by physician assistants and the relationship to state law and Medicare limitations.

5. B.2. Types of PA Services That May Be Covered

   Broad discussion of service categories that may fall within a physician assistant’s covered scope under applicable state authority.

6. B.3. Incident To

   Discussion of how incident-to concepts relate to services and supplies furnished in connection with physician assistant services.

7. B.4. Services Otherwise Excluded From Coverage

   General discussion of services that remain outside coverage even if they fall within a state-authorized scope of practice.

8. D. Physician Supervision

   Policy describing the supervising physician’s role and general oversight expectations.

9. E. Employment Relationship

   Rules governing who may be paid for physician assistant services and the types of entities that may bill Medicare.