Study: Some mid-level providers practice beyond scope

Nurse practitioners (NP) and physician assistants (PA) were originally envisioned to provide primary care services in underserved areas. To gauge NP and PA activity in non-primary care roles, Brett Coldiron, MD, and Mondhipa Ratnarathorn, MD, studied the scope of independent procedural billing to Medicare of difficult, invasive, and surgical procedures by medical mid-level providers. Their analyses of the 2012 Medicare Physician/Supplier Procedure Summary Master File, which reflects fee-for-service claims that were paid by Medicare, revealed that most (54.8%) of these procedures were performed in the specialty area of dermatology.

“It would be prudent to temper widening the scope of practice of mid-level providers by recognizing that mid-level providers are not solely limited to primary care, and may involve procedures for which they may not have formal training,” the study concluded.

Source: JAMA Dermatology