Medicare_Claims_Processing_Manual / Chapter_12 / CMS 100-04, 12 110

Why This Topic Matters

Understanding this guidance helps organizations review claims for physician assistant services against Medicare payment policy and recognize when additional hospital or surgical payment considerations apply. It is particularly useful for teams working with Medicare claims, surgical billing, and assistant-at-surgery documentation.

Article Sections

1. 110 - Physician Assistant (PA) Services Payment Methodology

   Introduces Medicare payment methodology for physician assistant services and notes related references to coverage policy. The section also discusses general hospital-related payment limits and claim submission requirements tied to assistant-at-surgery services.

2. 110.1 - Limitations for Assistant-at-Surgery Services

   Addresses limitations and payment considerations for assistant-at-surgery services under Medicare claims processing guidance. It also notes the need to avoid duplicate payment for surgical services when global surgery billing is involved.