Clinical Edge

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Dermatologic Procedures Independently Billed by NPPs

J Am Acad Dermatol; ePub 2018 Sep 15; Qi, Hibler, et al

A recent study demonstrated the increasing scope of practice of nurse practitioners (NPs) and physician assistants (PAs) in dermatology, despite limited training and lack of uniform regulations. Researchers conclude that in order to ensure quality and safety of care, it is prudent to set benchmarks for proper supervision and utilization of procedures in dermatology, as more non-physician practitioners (NPPs) expand their scope. They conducted a cross-sectional retrospective cohort analysis of dermatology practices in the 2014 Medicare Physician/Supplier Procedure Summary Master File, which reflects Part B carrier and durable medical equipment fee-for-service claims in the US. They found:

  • >4 million procedures were billed independently by NPs and PAs, which accounts for 11.51% of all.
  • Injection, simple repair, and biopsy were the most commonly billed by non-physician practitioners, but complex procedures were also increasingly billed independently by NPs and PAs.
  • Proportions of their claims are higher in the East Coast, Midwest, and Mountain states.

Qi Q, Hibler BP, Coldiron B, Rossi AM. Analysis of dermatologic procedures billed independently by non-physician practitioners in the United States. [Published online ahead of print September 15, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.08.047.