The Elm

The Medicare Payment Advisory Commission (MedPAC) proposed two policy options as potential recommendations to Congress regarding Medicare payment policies for APRNs and PAs. MedPAC's first policy recommends that Congress should require APRNs and PAs to bill "directly" and eliminate "incident to" billing. Under "incident to" billing, the provider bills using the physician's identification number at 100% of fee schedule amount, as opposed to "direct" billing, where the provider uses their own identification number and bills at a lower rate. The second proposed policy recommends that the Secretary of the Department of Health and Human Services should redefine Medicare's specialty designations for APRNs and PAs. MedPAC is scheduled to vote on final recommendations at its January 2019 meeting.