§414.56. Payment for nurse practitioners' and clinical nurse specialists' services.
42 C.F.R. § 414.56
Rural areas. For services furnished beginning January 1, 1992 and ending December 31, 1997, allowed amounts for the services of a nurse practitioner or a clinical nurse specialist in a rural area (as described in section 1861(s)(2)(K)(iii) of the Act) may not exceed the following limits:
For services furnished in a hospital (including assistant-at-surgery services), 75 percent of the physician fee schedule amount for the service.
For all other services, 85 percent of the physician fee schedule amount for the service.
Non-rural areas. For services furnished beginning January 1, 1992 and ending December 31, 1997, allowed amounts for the services of a nurse practitioner or a clinical nurse specialist in a nursing facility may not exceed 85 percent of the physician fee schedule amount for the service.
Beginning January 1, 1998. For services (other than assistant-at-surgery services) furnished beginning January 1, 1998, allowed amounts for the services of a nurse practitioner or clinical nurse specialist may not exceed 85 percent of the physician fee schedule amount for the service. For assistant-at-surgery services, allowed amounts for the services of a nurse practitioner or clinical nurse specialist may not exceed 85 percent of the physician fee schedule amount that would be allowed under the physician fee schedule if the assistant-at-surgery service were furnished by a physician.
Notes, amendments, and revision history
Amendments
[63 FR 58911, Nov. 2, 1998]
Source
Source: 56 FR 59624, Nov. 25, 1991; 57 FR 42492, Sept. 15, 1992, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302, 1395hh, and 1395rr(b)(l).
Source
Source: 55 FR 23441, June 8, 1990, unless otherwise noted.
Amendments
[63 FR 58911, Nov. 2, 1998]