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US · guidance

CMS Pub. 100-16, ch. mc86c17f, § 10.12

Non-Contracting Physician Assistant

activein force · 2026-08-25 – presentas-observed

(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)

A service provided to a cost plan or CMP enrollee who properly requested this service

from a contracted physician who employs a non-contracted physician assistant is

classified as a plan provided service. Therefore the physician assistant cannot look to the

member for direct reimbursement. The cost-plan member must be held-harmless from

incurring costs that exceed the copay that is otherwise applicable to the service in

question.

History

(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
a6652474c418b14d3ecc6a116f796ad4f93ec5a6e060ee01ff033297807947bf
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