Order Adopting Rules Relating to


A. Additions to the Chiropractic Fee Schedule (effective March 1, 2001) E. Establishment of Hospital Fees for Workers' Compensation Cases (effective January 1, 2001)
B. Adoption of a Durable Medical Equipment/Supply Fee Schedule (effective March 1, 2001) F. Reimbursement for Multiple Arthroscopic Procedures (effective March 1, 2001)
C. Deletion of Obsolete CPT Codes (effective March 1, 2001) G. Amendment of Industrial Commission Rule 104 (effective March 1, 2001)
D. Adoption of Fees for Physicians' Assistants (effective March 1, 2001)

Adoption of Fees for Physicians' Assistants

REVISION IN THE REIMBURSEMENT METHODOLOGY FOR PHYSICIAN ASSISTANTS PERFORMING EVALUATION AND TREATMENT SERVICES IN AN OFFICE, CLINIC OR FACILITY SETTING

The North Carolina Industrial Commission will allow reimbursement of evaluation and treatment services performed by a physician assistant that are considered within the physician assistantsí scope of practice. These services will be reimbursed at the rate of one hundred percent (100%) of the fee schedule allowance. Reimbursement will be allowed regardless of whether a supervising physician is on site at the office, clinic or facility or other place of treatment.

REVISION IN THE REIMBURSEMENT METHODOLOGY FOR PHYSICIAN ASSISTANTS PERFORMING THE SERVICES OF A MINIMUM SURGICAL ASSISTANT

The North Carolina Industrial Commission will allow reimbursement of physician assistant services, when assisting in surgery, as a minimal surgical assistant at the rate of seventeen percent (17%) of the fee schedule allowance.

The seventeen percent (17%) is based on eighty-five percent (85%) of the assistant surgeonís fee of 20 percent (20%). This rate would equal the same as that applied by the Health Care Finance Administration (HCFA).

The surgical procedure code should include modifier 81 (used to identify a minimum assistant surgeon). The name of the physician assistant should appear in Field 31 of the HCFA Form 1500.


Go Back to January 16, 2001 Order Adopting These Rules

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