Advanced Practice Billing Requirements:

CRNA’s

  • Be licensed as a registered professional nurse by the State where you practice
  • Meet any licensure requirements the State imposes with respect to non-physician anesthetists
  • Have graduated from a nurse anesthesia educational program that meets the standards of the Council on Accreditation of Nurse

Anesthesia Programs

Meet one of these criteria:

  • Have passed a certification examination of the Council on
  • Certification of Nurse Anesthetists or the Council on
  • Recertification of Nurse Anesthetists or
  • Have graduated from one of the nurse anesthesia educational programs that meets the standards of the Council on
  • Accreditation of Nurse Anesthesia Programs and passed the above certification examination within 24 months of graduation

NP’s (paid at 85% of the physician fee schedule)

Be a registered professional nurse authorized by the State in which you furnish services to practice as a NP in accordance with State law and meet one of these criteria:

  • Have obtained Medicare billing privileges as a NP for the first time on or after January 1, 2003, and
  • Are certified as a NP by a recognized national certifying body that has established standards for NPs
  • Have a Master’s degree in nursing or a Doctor of Nursing Practice degree
  • Have obtained Medicare billing privileges as a NP for the first time before January 1, 2003, and meet the certification requirements described above or
  • Have obtained Medicare billing privileges as a NP for the first time before January 1, 2001

PA’s  (paid at 85% of the physician fee schedule)

  • Be licensed by the State to practice as a PA and meet one of these criteria:
  • Have graduated from a PA educational program accredited by the Accreditation review Commission on Education for the Physician Assistant (its predecessor agencies, the Commission on Accreditation of Allied Health Education Programs, and the Committee on Allied Health Education and Accreditation) or
  • Have passed the national certification examination administered by the National
  • Commission on Certification of Physician Assistants