decisionhealth Newsletters, Part B News - 2020 Issue 1 (January)
Nurse practitioners, physician assistants kept rising in 2018, but other NPPs faltered
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Article Overview
This premium article examines how Medicare billing activity changed from 2015 to 2018 for several non-physician practitioner specialties, with emphasis on nurse practitioners, physician assistants, and other NPP groups. It is relevant to coders, compliance teams, and reimbursement analysts who monitor utilization trends, denial rates, specialty-level billing patterns, and the effect of quality reporting programs on claim volume.
Why This Topic Matters
Understanding specialty-level billing trends helps organizations benchmark claim volume, denial patterns, and reporting behavior over time. The article also highlights how changes in quality reporting can materially affect what appears on claims data, which matters for compliance review and coding analytics.
What You Will Learn
- How Medicare billing volume changed over a multi-year period for major non-physician practitioner specialties.
- Which broad service categories were most commonly billed by the specialties discussed.
- How denial rates and utilization trends can be compared across NPP groups.
- Why quality reporting activity can influence claim patterns for certain practitioners.
Who Should Read This
- Medical coders
- Coding auditors
- Compliance professionals
- Revenue cycle analysts
- Practice managers
- Healthcare consultants
Codes Discussed
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