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ED Coding and Reimbursement Alert

READER QUESTIONS:

Zoom in on Supervision Requirements

Published on Wed Sep 19, 2007

Question: If an NP or PA were to perform a diagnostic test, as long as it was within his scope of practice, am I correct that there are no supervision requirements?


Maine Subscriber


Answer: Nurse practitioners (NPs), clinical nurse specialists (CNSs) and physician assistants (PAs) may not function as supervisory physicians under the diagnostic tests benefit, according to Medicare rules.

Beware: Keep in mind that the supervision requirements for nonphysician ancillary personnel performing diagnostic tests are different from those for incident-to services. Diagnostic tests require general supervision, while incident-to services require direct supervision. 

But when these practitioners personally perform diagnostic tests as listed in the Balanced Budget Act of 1997, the supervision rules do not apply. An NP or PA may perform diagnostic tests as long as he follows the state scope-of-practice laws and the applicable state requirements for physician supervision or collaboration.

--Reader Questions and You Be the Coder reviewed by Michael A. Granovsky, MD, CPC, FACEP, president of MRSI, an ED coding and billing company in Woburn, Mass.
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