Reimbursement policy update: Nurse Practitioner and Physician Assistant Services — Professional

Beginning with dates of service on or after April 1, 2025, we will update the Nurse Practitioner and Physician Assistant Services — Professional reimbursement policy as indicated below.

The following services will be removed from the policy and are eligible for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

• Preventive Services
• Radiology Services

The following services will be added to the policy and will not be considered for a payment reduction when billed by a physician assistant (PA) provider:

• Drugs
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS)
• Laboratory Services and Laboratory Screening Tests

For specific policy details, visit the reimbursement policy page.