1 Tex. Admin. Code § 355.8093

Current through Reg. 49, No. 42; October 18, 2024
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.

1 Tex. Admin. Code § 355.8093

The provisions of this §355.8093 adopted to be effective July 1, 2006, 31 TexReg 5073; Amended by Texas Register, Volume 39, Number 51, December 19, 2014, TexReg 9888, eff. 12/28/2014