SECTION 355.8093. Reimbursement Methodology for Physician Assistants

(a) Covered professional services provided by a physician assistant (PA) are reimbursed the lesser of the PA's billed charges or 92 percent of the reimbursement for the same professional service paid to a physician (M.D. or D.O.). The claim for reimbursement must either be:

(1) billed under the PA's provider number; or

(2) a physician claim noting that the physician was supervising the activity of the PA and did not, on the date the service was rendered, make a decision about the patient's care.

(b) PAs are reimbursed at the same reimbursement level as physicians for laboratory services, x-ray services and injections.

Source Note: The provisions of this §355.8093 adopted to be effective July 1, 2006, 31 TexReg 5073; amended to be effective December 28, 2014, 39 TexReg 9887