Nonphysician Practitioners

Useful links

CMS Resources
Frequently Asked Questions
Relevant Society Position Statements
American College of Physicians’ statement “Nurse Practitioners in Primary Care”
Supervision and Collaboration: A Review of Definitions - This table provides practical information covering how statute, legislation, medical association, and authors define the terms “supervision” and “collaboration.”

CMS Resources

• Medicare Learning Network (MLN) web page for Medicare fee-for-service Advanced Practice Nurses and Physician Assistants
• The Medicare Claims Processing Manual, Chapter 12, (Physicians/Nonphysician Practitioners) section 30.6.13.
• The Medicare Claims Processing Manual, Pub. 100-04, Chapter 7 (SNF Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule))
• Medlearn Matters Article on Nonphysician Practitioner Frequently Asked Questions (SE # 0418)
  • Survey and Certification Memo 04-08: Physician Delegation of Tasks in Skilled Nursing Facilities (SNFs) and Nursing Facilities (NFs)
• The Skilled Nursing Facility Manual, Chapter V (Billing Procedures)
• The CMS Quarterly Provider Update Websites for Non-Physician Practitioners (NPPs)

FAQ - Frequently Asked Questions

Question: What is AMDA's policy on collaborating with nurse practitioners/advance practice nurses to perform physician services in nursing facilities and skilled nursing facilities?

AMDA formed an ad hoc work group that developed an article entitled Collaborative and Supervisory Relationships Between Attending Physicians and Advanced Practice Nurses in Long-Term Care Facilities that was published in the Journal of the American Medical Directors Association in January 2011. The work group contained representation from the physician and advanced practice nursing communities as well as the American Academy of Family Physicians and the American College of Physicians.

In addition, AMDA, the American Medical Association, the American College of Physicians, and the American Academy of Family Physicians all support collaboration and the physician's supervisory role. The following documents illustrate this point:

• Caring for the Ages, November 2008, "Physicians May Delegate Tasks, Not Supervision"
• ACP - Nurse Practitioners in Primary Care
• Centers for Medicare & Medicaid Services, HHS: §483.55 - Physician Services
• Physician Delegation of Tasks in Skilled Nursing Facilities (SNFs)and Nursing Facilities (NFs)
• Relevant Society Position Statements