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This web page is for Medicare fee-for-service Advanced Practice Nurses and Physician Assistants who provide services to Medicare beneficiaries. Medicare Learning Network (MLN) SpotlightsGo to the What's New page for the latest MLN products and announcements! Check it often! (Scroll to the bottom of this page to the "Related Links Inside CMS" section and click on the What's New link) PowerPoint Presentation"Advanced Practice Nurse/Physician Assistant PowerPoint Presentation" – This PowerPoint Presentation describes the roles and reimbursement rules that apply for CRNAs, PAs, NPs, CNMs, and CNSs who bill for services provided to Medicare beneficiaries. To view, download, or print, see the downloads section below. This Medicare APN/PA PowerPoint Presentation is composed of the following sections in the first zip file: - Introduction
- Certified Registered Nurse Anesthetist (CRNA)
- Physician Assistant (PA)
- Nurse Practitioner (NP)
- Certified Nurse Midwife (CNM)
- Clinical Nurse Specialist (CNS)
The second zip file contains the additional information sections. Internet-Only Manuals (IOM)Day to day program operating instructions, policies, and procedures based on statutes and regulations, guidelines, models, and directives. The IOM is used by CMS program components, contractors, and State survey agencies to administer CMS programs. (Scroll to the bottom of this page to the Downloads section; click on Internet-Only Manuals to access links to the IOM specific chapters related to APN/PA.) CMS Transmittals, MLN Articles, Job AidsCMS uses transmittals, MLN Matters Articles, and job aids to communicate new or changed policies or procedures that will be incorporated into the CMS Online Manual System. (Scroll to the bottom of this page to the Downloads section; click on CMS Transmittals, MLN Matters Articles, and Job Aids to access links to APN/PA specific transmittals, articles and job aids.) Code of Federal RegulationsTo access the Code of Federal Regulations, locate the link to the GPO website in the "Related Links Outside CMS" Survey and CertificationPolicy and Memos to States and Regions – See the Related Links Inside CMS below. Enrollment Procedures for Non-Physician PractitionersA "Medicare Enrollment for Physicians, Non-Physician Practitioners, and Other Health Care Suppliers" publication and the Medicare Enrollment Application can be found in the Downloads section below Physician Quality Reporting Initiative (PQRI)On December 20, 2006 the President signed the Tax Relief and Health Care Act of 2006 (TRHCA). Section 101 under Title I authorizes the establishment of a physician quality reporting system by CMS. CMS has titled the statutory program the Physician Quality Reporting Initiative (PQRI). PQRI establishes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment, subject to a cap, of 1.5% of total allowed charges for covered Medicare physician fee schedule services. See the Related Links Inside CMS section below. Part D Drug CoverageThis new benefit began January 1, 2006, and requires every Medicare beneficiary to make a decision regarding their prescription drug coverage. See the Related Links Inside CMS section below to download Educational Products for Health Care Professionals. National Correct Coding InitiativeCMS developed the Correct Coding Initiative (CCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Part B claims. See the Related Links Inside CMS section below to download the CCI Edits and Manual.
Page Last Modified: 08/09/2007 8:13:30 AM
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