Can non-physician practitioners such as nurse practitioners and physician assistants perform consultations?
According to CMS Publication 100-4, the Medicare Claims Processing Manual, Chapter 12, Section 30.6.10, subsections A (see attached link), “qualified nonphysician practitioners (NPP) may perform consultation services within the scope of practice and licensure requirements for NPPs in the state in which he or she practices.” In subsection E of the same section, CMS defines a “qualified” consultant as a practitioner that has expertise in a specific medical area beyond the requesting professional’s knowledge. We have seen instances when patients are referred to a specialty practice for consultations that are then done by NPPs (i.e. physician assistants or nurse practitioners) who then refer the patient to a physician in the same group for a therapeutic procedure. Subsequently, the physician then also performs a “pre-procedural” consultation which raises the issue why multiple consults were necessary. As a consultation may include the initiation of diagnostic and/or therapeutic services, i
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- Can non-physician practitioners such as nurse practitioners and physician assistants perform consultations?
