tci Medicare Compliance & Reimbursement - 2022 Issue Q4

Industry Notes: MAC Sees Uptick in ‘Scope of Practice’ Quandaries

If your practice is confused about whether a service is covered by Medicare for your provider type, you should review your supporting guidance to decrease denials, advises one Part B Medicare Administrative Contractor (MAC). “WPS Government Health Administrators has received an increase in provider questions regarding scope of practice guidelines for various services,” the MAC says in an alert. “This includes, but is not limited to, therapy assistants, physician assistants, nurse practitioners, nurses, or medical assistants.” Interesting: A provider’s scope of practice is determined by state licensing boards and is currently a hot topic...

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