In order to be consistent and compliant with CMS guidelines, ProviDRs Care will pay mid-level practitioners at 85 percent of the contracted rates for covered professional services incurred on or after April 1, 2016.
This policy applies to physician assistants and nurse practitioners which includes Certified Registered Nurse Anesthetists (CRNA). As of April 1, 2016, you will need to list the mid-level practitioner’s name in the servicing provider field when you submit claims for services rendered by a mid-level practitioner.
This policy does not apply to:
- Covered DME, orthotics, prosthetics, supplies, drugs, laboratory, radiology services and immunizations billed by a mid-level practitioner
For information on joining our network, reference www.ProviDRsCare.net.
Craig Sangals
Director of Contracting and Network Development