Assessing PA Value

May 1, 2007

Our orthopedic practice is considering hiring a physician assistant (PA) to perform various tasks. How much money should the PA bring into the office, considering that surgeons are freed to spend more time in surgery and less time on other clinical aspects of the practice?

Question: Our orthopedic practice is considering hiring a physician assistant (PA) to perform various tasks. How much money should the PA bring into the office, considering that surgeons are freed to spend more time in surgery and less time on other clinical aspects of the practice?

Answer: We’ve seen some normative data, but the best idea is to run the numbers for your office, since, in reality, there are great differences in how practices use a PA.

Estimate the PA’s salary and benefits. Then look at patient visits for a month. Estimate which visits, presumably mostly follow-up visits, would be handled by the PA. Make sure that number would actually fit into a PA schedule.

Then draw up a new hypothetical schedule for your MDs. Schedule an extra surgery in the time now open, capture your average reimbursement for surgeries and services, and see what the increased revenue is.

You'll want to make sure the MDs would actually do that extra work versus taking time off, or taking more time with patients.

You’ll also need to decide if the PA will be billing incident-to or billing under her own number. See the question “Billing Incident-To” for an explanation of the difference.

You’ll also want to look at each of your commercial payers’ policies on PA billing.