Medicare Part B Health Professionals – Education/Credentialing
Medicare Part B Health Professionals – Education/Credentialing
Health Care Professional |
BA |
Master’s |
Ph.D. |
Other
Credentialing |Social
Security Act |Physician
Supervision |Direct
Billing |42 CFR | |Physical Therapist | | | |yes[i] |§1861(p) |[ii], | |§484.4
§410.60 | |Physical Therapist in Independent Practice | | | |yes1 |§1861(p), 2d sentence |2 |√ |§410.60(c) | |Occupational Therapist | | | |yes[iii] |§1861(g) §1861(h) | |√ [iv] | §484.4
§410.59 | |Speech-Language Pathologist | |
√, or |
√ | yes[v], [vi] |§1861(ll)(3)(A) |2 | | §484.4 §410.62 | |Audiologist | |√, or |√ | yes 6, 7 |§1861(ll)(3)(B)
§1835(a)(2)(D) |2 | |§484.4 | |Physician Assistant | |
| |yes[vii] |§1861(aa)(5)(A) |General supervision |[viii] |§410.74 | |Nurse Practitioner | |
√ [ix] | |yes[x] |§1861(aa)(5)(A)[xi] |Collaboration |√ [xii] |§410.75(b)
§424.11(e)(5) | |Clinical Nurse Specialist | |
√ | | |§1861(aa)(5)(B)
§1833(a)(1)(O) |Collaboration |√ |§410.150(b)(16) | |Nurse-Midwife | | |
|
yes[xiii]
|§1861(gg)
§1833(a)(1)(K)
§1861(s)(2)(L) |No (unless required by State law) |√ |§410.77(a) §414.54 | |Qualified Psychologist | | |√ | |§1861(ii)
§1861(s)(2)(M) |No | √ |§410.71(d)
§410.150(b)(17) | |Clinical Social Worker | |
√, or |
√ |yes[xiv] |§1861(hh)
§1861(s)(2)(N)
§1833(a)(1)(F) |Agreement to consult[xv] |√ |§410.73(a)
§410.150(b)(18) | |Certified Registered Nurse Anesthetist | | | |yes[xvi] |§1861(bb)(2)
§1861(s)(11)
§1833(a)(1)(H) | | √ |§410.69 §419.2(c)(5) | |
-----------------------
[i] 42 CFR 484.4›慈牧摡慵整牦浯愠瀠票楳慣桴牥灡⁹畣牲捩汵浵愠灰潲敶祢›ㄨ
桔流牥捩湡倠票楳慣桔牥灡⁹獁潳楣瑡潩㭮漠㈨
桔潃浭獩楳湯漠汁楬摥䠠慥瑬摅捵瑡潩湡捁牣摥瑩瑡潩景琠敨䄠敭楲慣敍楤慣獁潳楣瑡潩㭮漠㌨
桔潃湵楣湯䴠摥捩污䔠畤慣楴湯漠桴流牥捩湡䴠摥捩污䄠獳捯慩楴湯愠摮琠敨䄠敭楲慣桐獹捩污吠敨慲祰䄠獳捯慩楴湯ഠ 倉瑡敩瑮洠獵⁴敢甠摮牥琠敨挠牡景愠瀠票楳楣湡愠摮甠摮牥愠瀠慬景挠牡灡牰癯摥戠⁹桰獹捩慩†ȍठ㈴䌠剆㐠㐸㐮›⁁数獲湯眠潨›愨
獉愠朠: Has graduated from a physical therapy curriculum approved by: (1) The American Physical Therapy Association; or (2) The Commission on Allied Health Education and Accreditation of the American Medical Association; or (3) The Council on Medical Education of the American Medical Association and the American Physical Therapy Association.
[ii] Patient must be under the care of a physician and under a plan of care approved by a physician.
[iii] 42 CFR 484.4: A person who: (a) Is a graduate of an occupational therapy curriculum accredited jointly by the Committee on Allied Health Education and Accreditation of the American Medical Association and the American Occupational Therapy Association; or (b) Is eligible for the National Registration Examination of the American Occupational therapy Association. . . .
[iv] Applies only to an occupational therapist in independent practice. See 42 CFR 410.59(c)(iii).
[v] 42 CFR 484.4: (1) Meets the education and experience requirements for a Certificate of Clinical competence in Speech Pathology or Audiology granted by the Speech-Language Hearing Association; or (2) Meets the educational requirements for certification and is in the process of accumulating the supervised experience required for certification.
[vi] Sec. 1861(ll)(A)(ii), (B)(ii): In the absence of State licensure, 350 hours of supervised clinical practicum, plus 9 months of supervised full-time services after obtaining degree, plus national examination.
[vii] 42 CFR 410.74(c): (1) Is a graduate of an educational program accredited by the Commission on Accreditation of Allied Health Programs; or (2) Passed national certification examination of the National Commission on Certification of Physician Assistants.
[viii] 42 CFR 410.150(b)(15): Direct billing is limited to the employer of the physician assistant.
[ix] 42 CFR 410.75(b)(1)(ii): For those NPs first applying for a Medicare billing number beginning January 1, 2003.
[x] 42 CFR 410.75(b)(1)(ii): Be certified as a nurse practitioner by a recognized national certifying body that has established standards for nurse practitioners. . . .
[xi] Services of a nurse practitioner are covered in a Rural Health Clinic (405.2414), Hospice (418.304), Critical Access Hospital (485.604, 85.631, 413.70(b)(4)), Rural Health Clinic and Federally Qualified Health Clinic (491.8), and in furnishing prostate screening tests (410.39).
[xii] 42 CFR 410.150(b)(16).
[xiii] 42 CFR 410.77(a): (2) Have successfully completed a program of study and clinical experience for nurse-midwives that is accredited by an accrediting body approved by the U.S. Department of Education; (3) Be certified as a nurse-midwife by the American College of Nurse-Midwives or the American College of Nurse-Midwives Certification Council.
[xiv] 42 CFR 410.73(a): (2) After obtaining the degree, has performed at least 2 years of supervised clinical social work; and (3) Either is licensed or certified as a clinical social worker by the State in which the services are performed or, in the case of an individual in a State that does not provide for licensure or certification as a clinical social worker --(i) Is licensed or certified at the highest level of practice provided by the laws of the State in which the services are performed; and (ii) Has completed at least 2 years or 3,000 hours of post master's degree supervised clinical social work practice under the supervision of a master's degree level social worker in an appropriate setting such as a hospital, SNF, or clinic.
[xv] 42 CFR 410.73(c).
[xvi] 42 CFR 410.68(b): Has graduated from a nurse anesthesia educational program that meets the standards of the Council on Accreditation of Nurse Anesthesia Programs, or such other accreditation organization as may be designated by the Secretary; and Has passed a certification examination of the Council on Certification of Nurse Anesthetists, or any other certification organization that may be designated by the Secretary; etc.
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- budget justification
- medi cal cost report pps rate setting
- brockton visiting nurse association
- top 10 most frequently asked questions about np billing
- read me first university of phoenix
- medicare part b health professionals education credentialing
- read me first
- model sop quality assurance quality improvement program
- incontinence products dhs16 141527
- nursepra 2 20 provider manual update
Related searches
- medicare part b immunization billing 2019
- medicare part b vaccine coverage 2019
- medicare part b formulary 2019
- medicare part b immunization billing
- medicare part b prescription coverage
- medicare part b application
- does medicare part b cover prescriptions
- medicare part b immunization billing 2020
- medicare part b medication coverage
- medicare part b medication formulary
- medicare part b pharmacy billing guidelines
- medicare part b pharmacy requirements