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Thread: Payment for np vs dr

  1. #1
    Join Date
    Apr 2007

    Question Payment for np vs dr

    AAPC: Back to School
    I was wondering if anyone could tell me if you get paid less when billing an np w/sa modifier than you do when you bill under the dr?? Thanks

  2. #2
    Join Date
    Apr 2007
    Sioux Falls South Dakota


    Medicare only allows 85% of the physician fee schedule when services are performed by an NPP (nurse practitioner, PA, etc.). For other insurance companies, you would need to check your contracts. Some reduce, some don't.
    Lucinda (Cindy) McGarry, CPC-P
    Applications Specialist
    Avera Health Plans
    Education Office Sioux Falls SD Local Chapter
    Past President Sioux Falls SD Local Chapter

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