Visits to the Stead Center are by appointment only. Please call the NCAPA office for more information. Read More »

Visits to the Stead Center are by appointment only. Please call the NCAPA office for more information. Read More »

The Pulse | November 2013

In this issue:
President’s Message: A Year to Remember
NCAPA Announces New Executive Director
Registration is Open: Recertification Exam Review Conference
Commercial Driver Medical Examiner Training: Register Now!
Member-Only Discounts: Get ‘Em in 2014!
Attention Behavioral Health PAs
More Good News for Behavioral Health PAs
Help for Providers from NCTracks
Evidence-Based Resources from AHRQ
Student Leadership Retreat
PAPA Annual Fall Seminar: Huge Success


President’s Message: A Year to Remember

By Don Metzger, PA-C

It has been my pleasure to serve as your president of the NCAPA. As my term draws to a close, I am reminded of the strong dedication of the NCAPA to be the voice of PAs in North Carolina. Below are some of these accomplishments:

  • Spoke out strongly against an AMA amendment that would have restricted a PA’s right to perform surgical procedures. The amendment was successfully defeated.
  • Supported the right for PAs to bill for psychiatric E&M codes.
  • Paid off the loan for the Stead center. The NCAPA is the first state constituent organization to build its own headquarters.
  • Recognized that a change in leadership was needed and hired a new Executive Director for the NCAPA.
  • Celebrated the extraordinary work of PAs in NC by establishing the PA of the Year Award which was awarded to Gail Curtis at NCAPA’s 37th Annual Summer Conference.
  • Strengthened our relationship with the North Carolina Medical Society.
  • Adopted new mission and vision statements to reflect our commitment to you the member.

And we will not stop! Your NCAPA is working hard to guarantee your right to practice under the Affordable Care Act. We must make sure that the title of Physician Assistant is in every line of every rule and regulation when it comes to authorizing medical providers. We must stand up for ourselves, and your NCAPA is here for you.


NCAPA Announces New Executive Director
By Don Metzger, PA-C
NCAPA President

It is my pleasure to announce that the North Carolina Academy of Physician Assistants has selected Cathie Feild as the Executive Director of the NCAPA. Cathie has been serving as the interim ED for the past six months, stepping into the role while the NCAPA embarked on a change in executive leadership. After a review of the NCAPA’s strategic plan for the next three years, a task force made the recommendation to hire Cathie as the NCAPA Executive Director and this was approved unanimously by the Board of Directors.

Cathie has a bachelor’s degree from Towson State University and Master of Arts in education from UNC-Chapel Hill. Her introduction to association management began while working for the Executive Director of the National Association for the Education of Young Children (NAEYC) in Washington, DC, shortly after college. Over the years, Cathie worked for a number of non-profit organizations, including the Certification Council of Nuclear Cardiology and the American Society of Echocardiography.

After moving to North Carolina in 2000, Cathie worked as the Program Specialist for the North Carolina Association for the Education of Young Children (NCaeyc), followed by a three-year term as their Executive Director. In addition, Cathie spent some time as NCAPA’s Member Services Coordinator, as well as serving as the interim Executive Director, before being hired as the permanent Executive Director, effective November 1.

Please welcome Cathie as the Executive Director of the NCAPA. We are confident she will help guide the Academy in its mission to provide innovative solutions to empower our members to enhance their careers and advocate for optimal health care.


Registration is Open! NCAPA Offers Two Great CME Opportunities


Annual NCAPA Recertification Exam Review Conference
February 24-28, 2014
Sheraton Imperial Hotel & Convention Center, Durham, NC

The conference agenda will mirror the PANRE Exam blueprint, and will also be an excellent review of all organ systems for any medical professional.  Registration is now open!  Please visit for more information.

The Sheraton Imperial Hotel and Convention Center is offering NCAPA conference attendees an Early Bird Special.  Book your hotel before January 1, 2014 and receive a special room rate. Click here for hotel information and reservations


Commercial Driver Medical Examiner Training
Friday, February 28, 2014
9 a.m.-4 p.m.
Sheraton Imperial Hotel, Durham, NC

Ready to get certified? The Federal Motor Carrier Safety Administration (FMCSA) requires all medical examiners who wish to provide DOT/CDL exams to be trained and certified by May 21, 2014. The NCAPA training course is designed to follow FMCSA training guidelines and will prepare the medical examiner to pass the national certification exam.   This course will offer 6 hours of Category 1 CME.*  Register now!

*The NCAPA plans to request  6 hours of AAPA Category I CME credit from the PA Review Panel.  The total number of approved credits is yet to be determined.


Member-Only Discounts–Get ‘Em in 2014!

Now is the time to renew your membership for 2014. Then take advantage of these great discounts to SAVE $$

  • CMEs: Major discounts on NCAPA’s CME opportunities, including Summer and Winter Conferences and (new this year!) Commercial Driver Medical Examiner Training.
  • Challenger: Discounts on comprehensive review and assessment courses.
  • Medelita: 15% discount on scrubs, lab coats, and more.
  • The Medical Letter: Discounted access to the full suite of electronic products offered by The Medical Letter.
  • Disability Insurance: Apply for individual disability income insurance at discounted rates through MassMutual.
  • Liability Insurance: NCAPA partners with Healthcare Providers Service Organization (HPSO), the nation’s number-one provider of professional liability insurance to healthcare professionals.

Questions? Contact any member of the Membership Committee, or Lee Busselman, Member Services Coordinator.


Attention Behavioral Health PAs
From the NCAPA Government Affairs Committee

The NCAPA  made inquiries and had been actively following the issue of PAs billing behavioral health E&M codes. We are happy to report that it appears that PAs can now finally bill behavioral health E&M codes through Medicaid. PAs do not need their individual provider number, yet, but this will eventually become a requirement (NCAPA and NCMS have encouraged PAs to obtain their individual provider number since NCTracks went online July 2013). The text of the August 2013 Medicaid Bulletin is reprinted below. Please contact the NCAPA if you have questions or if your claims using behavioral health codes are denied because you are billing as a PA.

Attention: Behavioral Health Providers
Physician Assistants/Associate-Level Licensed Providers: Taxonomy Codes
The N.C. Division of Medical Assistance (DMA) State Plan to allow Physician Assistants (PAs) to directly enroll as Medicaid providers has been approved. We expect these revisions to DMA Clinical Coverage Policy 8C to post in August. If they choose, PAs are now eligible to be enrolled as direct-enrolled providers. Following the guidance found in the October 2008 Medicaid Bulletin titled, “Modification in Supervision When Practicing ‘Incident to’ a Physician,” PAs may also continue billing “incident-to” a physician.
Per the contract with each Local Management Entity-Managed Care Organization (LME-MCO), LME-MCOs may choose to limit provider enrollment. However, because our state plan includes a set list of providers, LME-MCOs cannot deny the enrollment of any of these providers based solely on their type of licensure/profession. PAs and non-psychiatrist physicians may not be categorically excluded from enrollment when specialty behavioral health is considered within their individual scope of practice.
NOTE: Providers are not required to have a Medicaid Provider Number (MPN) prior to enrolling in the LME-MCO, but they are required to have a National Provider Identifier (NPI) number prior to enrollment. Not having an MPN should not affect enrollment in the LME-MCO.
Extension of Coverage for Associate-Level Licensed Providers Billing Outpatient Behavioral Health Services through LME-MCOs.
The coverage of Associate-Level licensed providers delivering outpatient behavioral health services as a reimbursable service under Medicaid and billed through the LME-MCO has been extended to January 1, 2014. The exception is Licensed Psychological Associates (LPAs) who can directly bill.
Taxonomy Codes
Remember that all providers are to use taxonomy codes on all claims. Taxonomy codes identify the provider type and area of specialization for health care providers. They are 10-character alphanumeric codes that allow providers to identify their specialties. With the exception of pharmacy providers, all providers are required to submit taxonomy codes on all claims.
To learn more about NPI and find correct taxonomy codes visit Providers can see a full list of taxonomy codes from the Washington Publishing Company at


More Good News for Behavioral Health PAs!

The article below is reprinted from the AAPA website.

AAPA Announces CMS Includes PAs as Authorized Providers in Community Mental Health Centers
In a final rule released on October 29, 2013, the Centers for Medicare & Medicaid Services (CMS) clarified and affirmed for the first time that physician assistants (PAs) are authorized providers in Community Mental Health Centers (CMHCs).  The rule marked the first time CMS released Conditions of Participation for CMHCs, which provide emergency and outpatient behavioral and mental health services for children, the elderly, and individuals who are chronically mentally ill. Citing concerns raised by AAPA that the lack of specific inclusion of PAs in a standard can imply to surveyors that PAs are not authorized to deliver certain medical services, CMS revised its proposed rule to include PAs in the CoP requirements, enabling CMHCs to utilize PAs in accordance with applicable federal, state, and local laws.  Specifically regarding PAs, CMS stated, “[w]e appreciate the comments regarding PAs. We agree that PAs play an important role in behavioral health. Therefore we have modified the language at Sec. 485.904(b) (8) to set requirements for PAs, and have re-designated the remaining elements accordingly.” The rule will become effective on October 29, 2014. 
PAs working in psychiatry expand access to quality behavioral and mental healthcare in communities across the country.  AAPA continues to advocate on behalf of PAs in psychiatry, recently meeting with senior leaders at the National Alliance on Mental Illness (NAMI), obtaining agreement on the creation of a joint policy paper highlighting the PA role in mental health that we expect will be published by the end of the year.


Help for Providers from NCTracks

The NCTracks team is offering in-person Provider Help Centers. NCTracks staff from Provider Enrollment, Provider Relations, Claims, and Prior Approval will be on site at locations across the state to assist NC providers with questions or concerns regarding NCTracks. No appointment is necessary. Providers will be assisted on a first-come, first-served basis. There are two Provider Help Centers scheduled for the remainder of November, both in Raleigh. See below for dates, times and locations.

9am – 5pm
NC Legislative Office Building, 300 N Salisbury Street, Raleigh NC 27603, Room 424

8:30am – 4:30pm
CSC Wycliff Building, 2610 Wycliff Road, Raleigh NC 27607, Lobby Room 160


Evidence-Based Resources from AHRQ Help PAs Maximize Time, Effectiveness

The U.S. Agency for Healthcare Research and Quality (AHRQ) provides free clinician research summaries, plain-language patient brochures and other resources that compare the benefits and risks of treatment options for common health conditions. AHRQ’s Treatment Options: Explore. Compare. Prepare. initiative helps physician assistants maximize time and effectiveness, and helps patients explore treatment options for their health conditions, compare the benefits and risks of each, and prepare to discuss them with their health care providers.

Access these free resources via AHRQ’s Clinical Bottom Line website for clinicians, or point patients to the patient-friendly Treatment Options website. To order free printed copies, including bulk quantities, call 1-800-358-9295 and use code C-02.


Student Leadership Retreat Attracts Record Number of Participants


The 2013 NCAPA Student Leadership Retreat (SLR) convened on Saturday, November 2 at the Estes Conference Center with 56 students in attendance. This is the highest enrollment ever for the retreat, which is now in its fourth year.

Participants included students from the physician assistant programs at Campbell, Duke, East Carolina, Elon, Methodist, Wake Forest, and Wingate universities.

The retreat was planned by the 2013 student representatives to the NCAPA Board of Directors: Molly Calabria, Campbell; Christi Blake, Duke; Robert “Crews” Edens, East Carolina; Jamie Seals, Elon; Cassandra Montoya, Methodist; Mary Jean “MJ” Leonardi, Wake Forest; and Andrew Sewalish, Wingate.

Speakers at the event included Alisha DeTroye, Zachary Hartsell, Jeff Katz, Charmeen Mack, Kate Peacock, Samantha Rogers, and Allison Ross.

Charlene Morris, NCAPA President-Elect, was on hand to welcome the retreat participants. Cathie Feild, NCAPA Executive Director, conducted a special session for the incoming 2014 student representatives to the Board of Directors to orient them to their role. The 2014 representatives are: Kondie Lykins, Campbell; Holly O’Sullivan, Duke; Rebecca Salman, East Carolina; Jamie Seals, Elon; Cliff Daub, Methodist; Kelsey Blaine, Wake Forest; and Ashton Youngers, Wingate.

Charlene Morris said of the event, “I was genuinely heartened to meet the incoming student representatives as well as many of the attendees.  I spoke to the students about my fulfillment from working in rural family medicine these past three decades and encouraged all to consider that path as they embark on their own educational journey.  The enthusiasm (of the students) was unmistakable and attending gave me just the powerful boost I need to begin my term as NCAPA president in two short months.”

The Student Leadership Retreat is an initiative of the NCAPA Student Affairs Committee, which is chaired by Samantha Rogers.


PAPA Annual Fall Seminar: Huge Success


The Piedmont Association of Physician Assistants (PAPA) held its 16th Annual Fall Seminar in honor of National PA Week on Saturday, September 21.  Well over 100 PAs and NPs participated in the event from across North Carolina. Six Category 1 hours were offered and the day was deemed a huge success by those in attendance.  PAPA hopes to see you next year at this annual conference.