Who does Medicare pay more for claims — Physicians or nurse practitioners? 5 findings

Researchers found Medicare pays nurse practitioners less than primary care physicians for claims, according to Medscape.

Advertisement

A study compared the amount Medicare paid on claims to primary care physicians and nurse practitioners in ambulatory settings and inpatient over a 12-month period.

Here are five findings:

1 For outpatient evaluation and management, Medicare paid PCPs an average of $705, quite higher than the $498 they paid NPs.

2. Medicare paid PCPs 11 percent more for inpatient services ($22,989) compared to NPs ($20,380).

3. For Part B services, Medicare paid PCP $2,955 and NPs $2,433.

4. PCPs were paid almost 15 percent ($1,911) more than NPs ((1,629) for adjusted work revenue value unit.

5. Researchers suggest the increasing demand for NPs to meet the needs of Medicare beneficiaries will likely reduce costs.

More articles on coding & billing:
Anthem-Cigna merger proposal brings out the skeptics — 5 takeaways
CMS, CDC release new ICD-10 codes, early: 4 insights
NY legislation would allow physician collective bargaining: 5 things to know

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.