Medical Assistance Question

Specialties NP

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Are nurse practitioners allowed to see medical assistant patients in the hospital? My billing people are saying that we will not get paid for a NP visit in the hospital, only if seen in the office. They say that medical assistance requires a doctor to see the inpt. This doesn't sound right to me. Can anyone shed some light on this for me. I am in Pennsylvania (not sure if that makes a difference). Thanks

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm sorry but am confused: what is "medical assistance"?

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Are nurse practitioners allowed to see medical assistant patients in the hospital? My billing people are saying that we will not get paid for a NP visit in the hospital, only if seen in the office. They say that medical assistance requires a doctor to see the inpt. This doesn't sound right to me. Can anyone shed some light on this for me. I am in Pennsylvania (not sure if that makes a difference). Thanks

To Trauma - Medical Assistance in PA is what the rest of the world calls Medicaid.

There is no mention in the billing rules that an NP cannot see an inpatient. The language specifically uses the word practitioner not physician. Its a very confusing system that can be hard to understand:

http://www.pacode.com/secure/data/055/chapter1150/chap1150toc.html

If you work for a mixed practice this might be an issue. The other issue is that only one person can claim payment each day. Also consultants do not get any payment for follow up visits only for the consult. Finally the payment is capped at $1000.

I would check with the Pennsylvania Coalition of NPs they are usually up on these issues:

http://www.pacnp.org/resources-faqs.php?action=view&id=8

David Carpenter, PA-C

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Specializes in Nephrology, Cardiology, ER, ICU.

Thanks for the explanation. I now understand. Thanks again.

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