Home Health: The Definition of an Allowed Practitioner

As per MM12615 the “Definition of an Allowed Practitioner” has been revised to read as follows (CR 12615):

Medicare Benefit Policy Manual Chapter 7 Section 30.2.1 – Definition of an Allowed Practitioner (Rev.11296, Issued: 03-25-22, Effective: 01-01-22, Implementation: 05-26-22) Allowed practitioners in addition to physicians, can certify and recertify beneficiaries for eligibility, order home health services, and establish and review the care plan. Allowed practitioners are defined at § 484.2 as a physician assistant (PA), nurse practitioner (NP), or clinical nurse specialist (CNS) as defined at this part. NPs, CNSs, and PAs are required to practice in accordance with state law in the state in which the individual performs such services. Physician assistant means an individual as defined at § 410.74(a) and (c). Clinical nurse specialist means an individual as defined at § 410.76(a) and (b), and who is working in collaboration with the physician as defined at § 410.76(c)(3). Nurse practitioner means an individual as defined at § 410.75(a) and (b), and who is working in collaboration with the physician as defined at § 410.75(c)(3). Individual states have varying requirements for conditions of practice, which determine whether a practitioner may work independently without a written collaborative agreement or supervision from a physician, or whether general or direct supervision and collaboration is required; however, a CNS and NP must work in collaboration with a physician in accordance with §§ 410.76(c) and 410.75(c) even if state laws governing collaboration do not exist.

This regulation was issued on 3/25/2022 and will be retroactively effective to 1/1/2022 with an implementation date of 5/26/2022.

Home Health: The Definition of an Allowed Practitioner

Related Content