Carrier Line Reduced Payment Physician Assistant Code

SAS Name

The code on the carrier (non-DMERC) line item that identifies the line items that have been paid a reduced fee schedule amount (65%, 75% or 85%) because a physician's assistant performed the service.


Source: NCH

Code Code value
BLANK Adjustment situation (where CLM_DISP_CD equal 3)
0 N/A
1 65% A) Physician assistants assisting in surgery B) Nurse midwives
2 75% A) Physician assistants performing services in a hospital (other than assisting surgery) B) Nurse practitioners and clinical nurse specialists performing services in rural areas C) Clinical social worker services
3 85% A) Physician assistant services for other than assisting surgery B) Nurse practitioners services