What modifier to use for physician assistant?
Asked by: Providenci Cronin | Last update: May 6, 2025Score: 4.3/5 (49 votes)
Does a PA need a modifier?
When a Physician Assistant (PA) provides services under Medicare, a specific modifier is used. This modifier distinguishes PA services from those provided directly by a physician. Typically, the modifier "AS" is applied when a PA assists at surgery.
What is the 82 modifier for PA?
CPT Modifier 82 - CPT Modifier 82 represents assistant at surgery by another physician when a qualified resident surgeon is not available to assist the primary surgeon. This modifier is not intended for use by non-physicians assisting at surgery (e.g., Nurse Practitioners or Physician Assistants/Physician Associates).
When should I use the SA modifier?
You should use modifier SA Nurse practitioner rendering service in collaboration with a physician for supervised NP services, when the insurer requires the modifier. Medicare does not accept modifier SA, and other payers may specify unique requirements.
When to use modifier 80 and 81?
Modifier 80 Assistant Surgeon: Surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). Modifier 81 Minimum Assistant Surgeon: Minimum surgical assistant services are identified by adding modifier 81 to the usual procedure number.
CPT Coding Modifiers for Assistant RNFA Surgery
How to bill for a physician assistant assisting surgery?
To bill for an assistant at surgery, use the appropriate CPT code for the primary procedure and append the correct modifier (80, 81, or 82) depending on the type of assistance provided. For non-physician assistants, use modifier AS, and ensure accurate medical documentation is included.
When to use modifier 90?
Independent laboratories shall use modifier 90 to identify all referred laboratory services. A claim for a referred laboratory service that does not contain the modifier 90 is returned as unprocessable if the claim can otherwise be identified as being for a referred service.
When should a medical assistant use a CPT modifier?
Similarly, a CPT modifier may describe whether multiple procedures were performed, why that procedure was necessary, where the procedure was performed on the body, how many surgeons worked on the patient, and lots of other information that may be critical to a claim's status with the insurance payer.
Can a NP assist in surgery?
Considering RNFA state licensing laws and hospital by-laws is important because they can vary significantly. Many states require NPs to also have their Registered Nurse First Assistant (RNFA) certification in order to function as first assist in the operating room.
What is the modifier for specialty physician?
HCPCS Modifier AF. This modifier is used to indicate a specialty physician.
What is the CPT modifier for assistant?
The CPT® code set features three assistant-surgeon modifiers: 80 (Assistant surgeon) 81 (Minimum assistant surgeon) 82 (Assistant surgeon (when qualified resident surgeon not available))
Can you bill for a certified surgical first assistant?
To bill services of an assistant surgeon (MD, NP, PA, CNS or RNFA acting as an assistant at surgery); use the surgical procedure code with modifier -80. The modifiers -81, 82 or –AS may also be used for assist services.
What is the 59 modifier used for?
Modifier 59 Distinct Procedural Service indicates that a procedure is separate and distinct from another procedure on the same date of service. Typically, this modifier is applied to a procedure code that is not ordinarily paid separately from the first procedure but should be paid per the specifics of the situation.
Can physician assistants bill?
PAs are authorized to treat new patients or established patients with new medical problems when billing under their name and NPI.
What is modifier 82 used for?
Modifier 82
This modifier is used when minimal surgical assistance is needed, but a qualified resident was not available (documentation required). First, check Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor List. Column A indicates if assistant at surgery allowed/not allowed.
Is there a modifier for covering physician?
The Q6 modifier, often referred to as the locum tenens modifier, is a billing code used in medical reimbursement to indicate that a substitute physician provided services.
Can a PA assist in surgery?
Can PAs Assist in Surgery? Yes, PAs are often the first assistants in surgery. Surgical PAs can independently perform certain procedures, such as cutting and draining abscesses, vein harvesting, and working as a part of a surgeon/anesthesiologist/nursing team. Surgical PAs are also the highest-paying PA specialty.
Who makes more, NP or PA?
Physician assistants can expect to earn around $121,530 per year, while a nurse practitioner's salary checks in around $123,780 per year. Choosing between a career as a nurse practitioner or a physician assistant may not be an easy one, as there's plenty of overlap between the two positions.
Can NP do liposuction?
Liposuction is most typically performed by an MD, DO, PA or NP; however, AmSpa believes that only an MD or a DO should be performing this procedure. Please check with your local medical board, nursing board or health care attorney for more information.
Does a physician assistant need a modifier?
Modifiers: Providers must indicate the appropriate PA modifier in conjunction with the HCPCS or CPT® code when the service was performed by a PA.
What is modifier 51 used for?
CPT guidelines explain the 51 modifier should apply when “multiple procedures, other than E/M services, are performed at the same session by the same individual. The additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s).”
What is modifier 92 used for?
Alternative Laboratory Platform Testing: When laboratory testing is being performed using a kit or transportable instrument that wholly or in part consists of a single use, disposable analytical chamber, the service may be identified by adding modifier 92 to the usual laboratory procedure code (HIV testing 86701-86703) ...
What is modifier 95 used for?
-95: Synchronous telemedicine service rendered via a real-time interactive audio and video communications system.
What is modifier 60 used for?
The CPT manual introduced modifier -60 in 2001 to allow providers to indicate when a procedure was more complex than normal due to an altered surgical field.
What is the 50 modifier used for?
Use modifier 50 to report bilateral procedures performed during the same operative session by the same physician in either separate operative areas (e.g., hands, feet, legs, arms, ears) or in the same operative area (e.g., nose, eyes, breasts).