decisionhealth Newsletters, Part B News - 1999 Issue 6 (June)
BBA okays NPs/PAs/CNSs for CPO services
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Article Overview
This article explains a Medicare payment and policy issue affecting nurse practitioners, physician assistants, and clinical nurse specialists in care plan oversight billing. It is relevant to physician offices, nonphysician practitioners, Medicare carriers, and coding/billing staff who follow HCFA guidance and carrier policy changes. The discussion focuses on the Balanced Budget Act of 1997, Medicare coverage interpretation, carrier denial concerns, and possible future policy action.
Why This Topic Matters
The article highlights a transitional Medicare policy area where billing practices, carrier interpretation, and federal guidance may not be aligned. It matters because organizations that bill Medicare for care plan oversight need to understand how the issue is being viewed by HCFA and carriers.
What You Will Learn
- How Medicare policy after the Balanced Budget Act of 1997 affected care plan oversight billing
- Why carrier payment for nonphysician practitioner services remained uncertain
- How HCFA and Medicare carrier officials were interpreting the issue
- What kinds of future policy updates were being anticipated
Who Should Read This
- Medical coders
- Billing staff
- Compliance staff
- Physician office administrators
- Nonphysician practitioners
- Medicare reimbursement professionals
Codes Discussed
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