What third party payors provide reimbursement for nurse practitioner services?
In Michigan, the following payors provide reimbursement to NPs: Medicaid – recognizes NPs (also CNMs and CRNAs) and provides direct reimbursement Medicare Secondary (“Gap”) Payors – Many commercial insurances recognize NPs, as Medicare does, and provide direct reimbursement Federal Insurances – Champus, BC/BS Federal and Railroad Medicare recognize NPs (also CNMS and CRNAs) and provide direct reimbursement Blue Cross/Blue Shield of Michigan – recognizes NPs, CNMs and CRNAs, and provides direct reimbursement Commercial Insurances & Traditional Indemnity Plans – Although it varies among companies, many recognize NPS and provide direct reimbursement HMOs – There are 29 licensed HMOs in Michigan. Many of the 19 HMOs that provide Medicaid services will allow NPS to have provider status and receive direct reimbursement. However, the majority, with a few exceptions, of HMOs licensed for commercial business do not allow NPs to be o their provider panels. Therefore, it is important to inquire o
