Member Login
AASPA Members! Access the AASPA Vault and other members-only information.
Reimbursement
TweetPA services are reimbursable at a percentage of the physician rate by most major federal programs, insurance companies and workers' compensation programs.
Reimbursement at a Glance
PAs are reimbursable under Federal Health Laws that regulate Medicare. Most insurance companies also cover services performed by the physician/PA team. The Medical Group Management Association 2001 Physician Compensation survey found that the average total charges for a surgical PA in that year was $321,225.
Medical Reimbursement
| Care Setting | Reimbursement Rate |
Office/Clinic when physician is not on site Home visit/House Call |
85% of physician fee |
First assisting at surgery in all settings |
85% of physician first assist fee schedule |
Office/Clinic when physician is on site |
100% of physician fee |
Federally Certified Rural Health Clinics |
Cost-based |
HMO |
On capitation basis |
Other Reimbursement
| Reimbursing Program/Entity | Reimbursement Rate |
Medicaid fee-for-service or managed care programs |
Varies by State |
Private insurance programs (fee-for-service, HMOs, PPOs, etc.) |
Varies by Program |
Workers’ Compensation |
Varies by State |
TRICARE (formerly CHAMPUS) covers all medically necessary services |
Varies by Program |
For more information on PA reimbursement, visit AAPA.org.
