CMA Today Referenced in Part B News

As many readers of this blog know, I write at length about legal issues affecting the medical assisting profession in each issue of CMA Today, the official publication of the American Association of Medical Assistants. Recently, one of those articles was referenced in a question-and-answer piece in Part B News. (Note: Subscription required.)

The write-up discusses CPT code 69209 (Removal of cerumen using irrigation/lavage) and whether the procedure can be billed if a medical assistant performs it. The author notes several important considerations—for example, the differences in state law and the vagaries of some CPT language—in addition to discussing the CPT definition of “clinical staff” as it relates to medical assistants. Ultimately, the author states the following:

In aggregate, when it comes to medical assistants being eligible to perform services incident to a physician, the answer is “generally yes,” according to recent guidance from the American Association of Medical Assistants (AAMA).

The language the author cited was from my article “‘Incident-to’ billing: Medical assistants’ services under the Medicare CCM program,” which can be found on the AAMA website.

Order Entry Requirements for Non-Physician Practitioners

I was recently asked whether non-physician practitioners (e.g., nurse practitioners and physician assistants) must meet the meaningful use order entry requirements under the Medicaid Electronic Health Record (EHR) Incentive Program.  The answer is yes.

The following are considered “eligible professionals” (EPs) who can participate in the  Medicaid EHR Incentive Program:

• Physicians (primarily doctors of medicine and doctors of osteopathy)
• Nurse practitioners
• Certified nurse-midwives
• Dentists
• Physician assistants who furnish services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant

All participating EPs must meet the computerized provider order entry (CPOE) requirements of the Incentive Program in order to receive incentive payments.

Eligible Professionals for Medicare and Medicaid EHR Incentive Programs

The Medicare Electronic Health Record (EHR) Incentive Program and the Medicaid EHR Incentive Program are two similar, but different, federal initiatives.  Questions have arisen about which health care providers are eligible to participate in the Medicare Program, the Medicaid Program, or both.

Medicare-only eligible professionals (EPs) are optometrists, podiatrists, and chiropractors. Medicaid-only EPs are nurse practitioners, nurse midwives, and physician assistants—when working at a federally qualified health center (FQHC) or rural health clinic (RHC) that is led by a physician assistant.  In some circumstances, physicians, osteopaths, and dentists could be eligible for both the Medicare and Medicaid Incentive Programs.