DizzyJ Posted December 28, 2016 Share Posted December 28, 2016 Question....I have exhausted google (or am just not a smart browser) and can't find the answer. My employer (outpatient psych practice) is telling me the PMH-NP are reimbursed at 100%, while I am only at 85%. I am fully aware PAs are at 85%. The latest CMS guide I can find (https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Mental-Health-Services-Booklet-ICN903195.pdf) lists both NP and PA at 85% reimbursement. This document is from 2015 though. Any insight? Link to comment Share on other sites More sharing options...
cop to pa Posted December 29, 2016 Share Posted December 29, 2016 What state? I vaguely remember one allowing 100% for NP in MH or primary care. Link to comment Share on other sites More sharing options...
rpackelly Posted December 29, 2016 Share Posted December 29, 2016 Depends on your payor and state. Michigan Medicaid is 100 percent for both. I believe Medicare is 85 percent for both just as you do. Link to comment Share on other sites More sharing options...
DizzyJ Posted January 3, 2017 Author Share Posted January 3, 2017 I'm in California. I didn't think about it being different depending on the state, but that makes sense. Link to comment Share on other sites More sharing options...
rpackelly Posted January 3, 2017 Share Posted January 3, 2017 Yeah, Medicaid is run by the states but funded by the Feds, states create the rules. Medicare is run by the Feds, they created the 85 percent rule. The private companies are all over the map on psych reimbursement. Link to comment Share on other sites More sharing options...
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