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Reimbursement for Nurse Practitioners

  1. Default Reimbursement for Nurse Practitioners
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    Has anyone heard of this going to 100% from 85%. One of the NP's said that Jim Collins was at a dinner she was at about a year ago and told her this.....Did I miss something??

  2. #2
    NPPs (non physician practioners) are reimbursed at 85% of the physician fee schedule thru Medicare.

    If they are providing services incident-to a physician they will be reimbursed at 100%.

    As far as I know nothing has changed, it has been this way for as long as I can remember.

    Laura, CPC, CEMC

  3. #3
    If a NP is seperately enrolled into the Medicare program, and you bill as such, the reimbursement is 85% of the fee schedule.

    If you are billing incident-to, granted all documentation supports, you are paid 100% because you are billing under the physician's name and provider numbers.

    Laura is correct, nothing has changed.

  4. #4
    Columbia, MO
    Oh absolutely, that is true, but there are the underserved areas where an Np can bill with their own number and be reimbursed 100%. I am more familiar with this in primarily rural areas where access to providers is limited.

    Debra A. Mitchell, MSPH, CPC-H

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