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Primary Care Coding Alert

Reader Question:

Check Balanced Budget Act for Supervision Rules

Published on Sun Nov 11, 2007

Question: If a nurse practitioner (NP) or physician assistant (PA) performs a diagnostic test, as long as it is within his scope of practice, am I correct that there are no supervision requirements?


Maine Subscriber
Answer: 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. Beyond that, the Medicare supervision rules that otherwise apply to nonphysician ancillary personnel do not apply to NPs and PAs when they personally perform diagnostic tests as listed in the Balanced Budget Act of 1997. 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 physician supervision.
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