FOR NP's in AL working and billing as First Assist

U.S.A. Alabama

Published

Hello,

I am an ACNP in ALabama of now 5 years, and and am actively interviewing with a Urologist who has asked me about NP's being able to bill as First Assist. I know they do, but wondered if I will generate more revenue for our clinic staying and seeing patients in clinic versus an occasional day or two a week as his first assist also.

Any links to what's out there for billing for NP's as FA is greatly appreciated.

Hello,

I am an ACNP in ALabama of now 5 years, and and am actively interviewing with a Urologist who has asked me about NP's being able to bill as First Assist. I know they do, but wondered if I will generate more revenue for our clinic staying and seeing patients in clinic versus an occasional day or two a week as his first assist also.

Any links to what's out there for billing for NP's as FA is greatly appreciated.

As an NP you will receive 14.5% of the surgeons fee. This will usually be more than clinic follow ups but may be less than a consult. I haven't worked urology so I don't know how many in office procedure you would do. These are probably the most profitable in most practices. Two other issues. Find out what the hospital requires to be able to assist. Many hospitals require RNFA to assist in the OR. This would require additional training. The other issue is that only certain surgeries allow for a first assist. A common problem with surgeons that don't understand how to bill for first assist is they have you help on all surgeries. This means you are doing the case for free. On cases that don't require first assist you shouldn't be assisting. Instead you should be following inpatients or seeing patients in the office. The first provides more downstream revenue by allowing the physician to get more billable procedures. The second allows you to increase your billing.

You might post this question is the NP forum as there are a few NPs there that assist.

David Carpenter, PA-C

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