decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Medicare_Carriers_Manual / 2154 / 2154
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Article Overview
This article is a Medicare Carriers Manual section focused on nurse-midwife services. It outlines the general coverage framework, who is recognized as a certified nurse-midwife, the scope of covered and noncovered services, relationships with physicians, and where services may be furnished. It is useful for coders, billers, compliance staff, and providers who need to understand Medicare coverage policy for nurse-midwifery under the manual guidance.
Why This Topic Matters
Coverage and payment policy for nurse-midwife services can affect claim submission, reimbursement, and compliance with Medicare requirements. This section helps readers understand the policy scope and the types of service situations addressed by the manual.
Article Sections
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Ed. Note
Editorial cross-reference guidance pointing readers to related manual material on nurse midwives.
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2154. NURSE-MIDWIFE SERVICES
General Medicare coverage policy for nurse-midwife services, including effective dates and payment basics.
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Certified Nurse-Midwife Defined
Qualifications and recognition criteria used for determining who is treated as a certified nurse-midwife under the manual.
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Covered Services
The scope of services addressed by the coverage policy, including general coverage periods, incident-to services, and related limitations.
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Noncovered Services
Types of services and situations that remain outside Medicare coverage and related boundaries for newborn care.
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Relationship With Physician
Discussion of physician relationships, state requirements, and billing/payment considerations for nurse-midwife services.
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Place of Service
Locations where nurse-midwife services may be furnished under the manual without a place-of-service restriction.
What You Will Learn
- How Medicare frames coverage for nurse-midwife services
- What qualifications are described for certified nurse-midwives
- Which broad categories of services are addressed as covered or noncovered
- How physician relationships and state requirements are discussed in the manual
- Where nurse-midwife services may be furnished under the policy
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Nurse-midwives
- Physician practices
- Hospital and clinic administrative staff
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