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Reimbursement by Medicare.

A Davis

    Physician Assistant (American Academy of Physician Assistants)
    |May 10, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Medicare Part B now reimburses Physician Assistant (PA) services, but coverage is limited. Understanding these new PA reimbursement rules is crucial for PAs to assist patients in securing payment.

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    Area of Science:

    • Healthcare Policy
    • Medical Reimbursement
    • Physician Assistant Studies

    Background:

    • Medicare Part B reimbursement for Physician Assistant (PA) services has been implemented for six months.
    • Current legislation offers partial coverage for PA services, primarily in surgical assisting and facility-based care.
    • Understanding the implications of these new Medicare reimbursement policies is essential for PAs and patient access to care.

    Purpose of the Study:

    • To inform Physician Assistants (PAs) about the implications of new Medicare Part B reimbursement.
    • To encourage PAs to help patients navigate the process of securing Medicare payments for PA services.
    • To advocate for expanded Medicare coverage for all PA services.

    Main Methods:

    • Analysis of current Medicare Part B legislation pertaining to PA services.

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  • Review of implementation challenges and successes of the new reimbursement policy.
  • Recommendations for PAs and state chapters based on the author's experience with the American Academy of Physician Assistants' Legislative and Governmental Affairs Committee.

    • Main Results:

    • Medicare Part B reimbursement for PA services is now active but restricted in scope.
    • The current legislation is a partial success, with implementation challenges anticipated.
    • Coverage is limited to specific settings: surgical assisting, hospitals, skilled nursing facilities, and intermediate care facilities.

    Conclusions:

    • PAs must understand the full scope of Medicare reimbursement to aid patient payment.
    • State chapters and PAs should engage with local carriers and continue lobbying for comprehensive coverage.
    • Despite limitations, the new reimbursement is a step towards broader recognition of PA services under Medicare.