23 Miss. Code. R. 203-7.2 - Nurse Practitioner Services and Reimbursement

A. The Division of Medicaid covers services provided by Advanced Practice Registered Nurses (APRNs), also referred to as Nurse Practitioners (NPs), certified by the state in which they practice, for services rendered within the scope of practice allowed by their protocol.

B. NPs must bill the appropriate Current Procedure Terminology (CPT) code for services rendered and follow the same rules and guidelines as physician services.

C. The Division of Medicaid reimburses NPs at ninety percent (90%) of the physician fee for the service.

D. The Division of Medicaid does not reimburse for:

1. An NP as an assistant surgeon,

2. Multiple providers when a service is performed simultaneously with another provider, or

3. NP services if the collaborating physician is not a Mississippi Medicaid enrolled provider or an Ordering, Referring or Prescribing (ORP) physician.

Notes

23 Miss. Code. R. 203-7.2

42 C.F.R. § 440.166; Miss. Code Ann. §§ 43-13-117, 43-13-121, 73-15-20.

Amended 12/1/2019