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Nurse Practitioners of Central Pennsylvania

Healthcare and NP Scope of Practice

Posted over 8 years ago by Lori Norris

Dear Members and Colleagues,

I have copied and pasted an excerpt from Carolyn Buppert, NP JD regarding home healthcare and NP scope of practice.Please tell me that our Political Action Committee is working on changing these codes of federal REgulations that are so restrictive for NPs attempting to provide home health services for our clients.

In summary, nothing in the federal language on home care gives NPs the authority to order medications or therapy for a home care patient through the home care agency process or to discharge a patient from home care.

However, if a patient needed a medical visit in his or her own home, and an NP conducted the visit, the NP could perform a history and physical examination, order medications and treatment, and bill for the visit, using one of the Evaluation/Management CPT codes. If necessary, the NP could order durable medical equipment. Some Medicare contractors have the following provisos, however:

  • The NP must be treating the beneficiary for the condition for which the item is needed:

  • The NP must be practicing independently of a physician; and

  • The NP must bill Medicare for other covered services using his or her own provider number.[4] Sometimes the laws don't make much sense. However, a change to allow NPs more authority with home care agencies would require an Act of Congress.

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