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PA Direct Pay

ATTENTION PAs!

Physician Associates move closer to the eligibility of receiving direct payment under the Medicare Program!

The Center for Medicare a Medicaid Services (CMS) issued a PA direct payment authorization language in the 2022 proposed physician fee schedule.

Medicare permits health care professionals such as Physicians, APRNs, Physical Therapists, Psychologists, Podiatrists, Social Workers, and others who will bill Medicare, the ability to receive Direct payment from them. Whereas it stands today, PAs do not have that same ability.

Not having access to direct payment impedes PAs’ ability to have full participation in certain practice opportunities.

Medicare direct payment will be important to PAs who choose to:

1. Practice as self-employed independent contractors.

2. Own their own practice and/or medical cooperation &

3. Work in certified Rural Health Clinics (RHS) and want to be sure to receive reimbursement for “carved out” services. 

Many Doctors and APRNs usually assign their Medicare reimbursement to their W-2 employer which will likely be the case for many PAs. Nevertheless, PA’s who want the opportunity of working in nontraditional practice agreements to have the option to receive direct payments like other health care professionals.

It is important for you to know your state laws and authority because if state law prohibits PAs from receiving direct payment, Medicare will not override those state provisions. 

To learn more, check out this article by AAPA :

https://www.aapa.org/news-central/2021/07/medicare-moves-to-implement-pa-direct-pay/

If you are a PA looking to take the entrepreneurial leap in owning your own clinical practice, let Doctors for Providers match you to one of our wonderful Collaborating Physicians!

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