RadOnc PA

[meaghanmize]

Hi everyone! I am a new grad and started my job as a RadOnc PA about 6 weeks ago. I love it so far, but I am curious about one particular aspect - I know I am able to see consults and follow-ups as long as the supervising physician is on the premises, but does the same go for OTV's? As I am the first PA this office has hired, we are all learning exactly what my role is.

I reached out to ASTRO, who sent me the following: 

"The patient may be seen by a physician extender such as a physician’s assistant or a nurse practitioner in consultation, follow-up appointments and during the course of radiation therapy. However, since their training does not include the necessary background for radiation physics, the biology of cancer and other integral components of radiation oncology care, CMS has deemed that a PA or NP may not provide or bill the treatment management CPT codes 77427, 77431, 77432 or 77435. If a physician extender independently provides the allowed E/M service (under the supervision of the physician) and they bill under their own provider number, then the service would be billed at 85% of the normal physician rate. However, no additional E/M codes can be billed during the course of treatment and up to 90 days post-treatment. Also, Medicare patients cannot be billed for daily treatments if the supervising physician is not present on the hospital campus or at the freestanding center when the treatment was delivered."

I believe the fact that I cannot bill for CPT 77427 means that I cannot aid the Physician with OTV's. Please let me know if anyone could help me understand this better and if you have been or are a RadOnc PA, any advice on how I should shape my role here would be greatly appreciated!