Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 355 - REIMBURSEMENT RATES
Subchapter J - PURCHASED HEALTH SERVICES
Division 5 - GENERAL ADMINISTRATION
Section 355.8093 - Reimbursement Methodology for Physician Assistants
Universal Citation: 1 TX Admin Code ยง 355.8093
Current through Reg. 49, No. 38; September 20, 2024
(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.
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