Rules and Regulations Relating to Roles of Nonphysician Providers in Radiology Practices

Abstract

Nonphysician providers (NPPs) in radiology practices include nurse practitioners, physician assistants, and radiologist assistants. The number of NPPs has been increasing both within and outside of radiology departments. In order for leaders in radiology departments to incorporate NPPs effectively into their practice, they require nuanced knowledge of appropriate coding and billing for services these professionals render. Furthermore, the existing body of literature suggests that with a defined and appropriate scope of practice and proper supervision, NPPs can provide care that is at least equivalent to that provided by attending physicians for narrowly defined tasks. A broader understanding of the rapidly evolving NPP workforce both within radiology practices and throughout other health care specialties will inform practice leaders who are adapting to a health care system that is moving rapidly toward value-based incentive payment models. ©

Advanced Practice Providers

“…Advanced Practice Providers Billing for Services qualified health providers that acquire their own national provider identification number which allows billing under their own identification numbers for services provided [29]. The most recent changes by Centers of Medicare & Medicaid Services (CMS) were allowing the RAs the ability to perform diagnostic testing under "direct supervision" rather than "personal supervision" starting in January 2019.…”

“…In 1948, the American Nurses Association (ANA) was instrumental in presenting outcome data to prove how quality, cost-effective care provided by advanced practice nurses (APNs) should be [18,20,21,28,29,32,36,37,[49][50][51][52][53][54][55][56][57][58][59][60] eligible for Medicare reimbursement. The value of this data was not truly recognized until the 1990s due to the barriers that existed.…”