Mid-level provider billing

We accept mid-level provider billing when serving in two distinct roles:

1. Mid-level providers assisting with surgery
   
   Physician assistants (PAs) or nurse practitioners (NPs) employed by a physician group may contract with Priority Health and bill directly for surgical assists or facility rounding. Contact your contract administrator to determine your eligibility.
   • Surgery assists should be billed using the HCPCS Level II Modifier – AS.
   • All office-based procedures performed by PAs or NPs in a specialist’s office should continue to be billed under the participating supervising physician.
2. Mid-level credentialed providers in a PCP Office
   
   Priority Health may credential PAs or NPs providing office-based primary care services. These providers are required to meet Priority Health credentialing criteria, which includes entering into an agreement with a collaborating physician who is contracted and credentialed with Priority Health. Contact your contract administrator for the application form and contracts.

If you have not been introduced to your contract administrator, contact the Provider Helpline at 800-942-4765.

Topics: Billing