Medicare and Full Practice Authority

[tnRNMedic, ADN, RN, EMT-P]

Hey Everone!

So I am an FNP student but this really doesn't fit in the student section. I am working on a paper and wanted to reach out and get some input from those who are out there practicing. 

My question is: Medicare participation and billing requirements state that an APRN, or NPP as CMS calls them, have a collaborative agreement with a physician in order to participate/bill Medicare. How does this work in states with full practice authority? Can you still see Medicare patients without having a collaborative agreement? Or do you have one just for Medicare patients?

Thanks so much!

Brendan, MSN(c), BA, AASN, RN, CCP, CEN, NRP

[NurseBlaq]

I don't have an answer for you but it would be interesting to see the outcome of these findings which were presented to Congress. http://www.medpac.gov/-blog-/the-commission-recommends-aprns-and-pas-bill-medicare-directly-/2019/02/15/improving-medicare's-payment-policies-for-aprns-and-pas

[djmatte, ADN, MSN, RN, NP]

Even in full practice states, many insurance companies still require a collaborator. I believe Medicare included. One of the biggest reasons I would opt for a direct primary care model of I ever went independent. No insurance. Pay a monthly fee of $50. See or interact with your provider as often as necessary. I won’t feel I need to hit a quota of patients per day to make money and I can more easily justify alternate forms of patient evaluation where insurance companies don’t always pay for.