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Posted By: Susanne J. Phillips, DNP, APRN, FNP-BC
November 29, 2019
On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule final rule, which will positively affect the NP and PA preceptor documentation burden. For those of you providing clinical teaching rotations for advanced practice registered nurse (APRN) and/or PA students, you may be aware that in March 2018 CMS reduced the documentation burden for physician preceptors. This change authorized teaching physicians to verify and sign student documentation components of evaluation and management (E/M) services rather than have to re-document the work themselves. Unfortunately, this created unintended consequences for APRN and PA preceptors and the students they supervise.
In an era where productivity in patient care has been a major driver of reimbursement, the 2018 rule caused many practices to abruptly discontinue precepting APRN and PA students—creating a crisis in NP and PA education. As a result, the American Association of Nurse Practitioners (AANP), the American Academy of PAs (AAPA), nursing, and physician stakeholders worked diligently to mobilize their constituencies and to request changes to the 2020 final rule. Through lobbying efforts and regulatory comments, CMS revised the language, thereby creating documentation requirement parity among all clinician preceptors.
Effective January 1, 2020, APRN and PA preceptors may review and verify medical record documentation entered by other licensed health care providers and members of the health care team, as well as student APRNs and PAs. This update will ultimately improve patient access to high-quality health care.
There are additional changes affecting APRN and PA providers including, but not limited to, updates to Medicare telehealth service reimbursement, E/M services documentation and reimbursement, physician supervision requirements for PAs, and payment for transitional care management services. Click the links in the references below for additional information.
- Centers for Medicare and Medicaid Services. Finalized policy, payment, and quality provisions changes to the medicare physician fee schedule for calendar year 2020. www.cms.gov/newsroom/fact-sheets/finalized-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar Accessed November 26, 2019.
- Centers for Medicare and Medicaid Services. Final rule and interim final rule: 42 CFR parts 403, 409, 410, 411, 414, 415, 416, 418, 424, 425, 489, and 498. s3.amazonaws.com/public-inspection.federalregister.gov/2019-24086.pdf Accessed November 26, 2019.
Filed under: Health Policy and Trends