NPs/PAs

Why This Topic Matters

The topic matters because carrier interpretation, supervision status, and billing setup can determine whether diagnostic test claims are paid correctly. Practices that use nonphysician practitioners for testing need to know how Medicare policy aligns with fee schedule guidance and how supervision changes may affect workflow and reimbursement.

Article Sections

1. Medicare policy on NPP billing for diagnostic tests

   Overview of CMS policy language addressing nonphysician practitioner furnishing and billing of diagnostic tests under Medicare. The section focuses on the general policy context and how carrier interpretations may differ.

2. Cardiology-related diagnostic tests and supervision levels

   A table-style discussion of diagnostic tests grouped by Medicare supervision category. It presents examples relevant to cardiology practices and notes later changes to supervision levels.

3. Codes changed from general to direct supervision

   A short list identifying procedures whose supervision category was revised in the fee schedule update. The section is limited to the change category and does not provide selection guidance.

4. Codes changed from personal to direct supervision

   A second list of procedures affected by revised supervision status in the update. The section is presented as part of the overall discussion of supervision changes.

5. Impact of supervision changes on cardiology practice

   Discussion of operational and payment implications for practices using nonphysician practitioners to perform diagnostic testing. The section addresses the broader effect of the CMS update on workflow and billing.