Analysis of dermatologic procedures billed independently by nonphysician practitioners in the United States.
Medicare
dermatology
dermatology practice pattern
nonphysician practitioner
nurse practitioner
physician assistant
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
13
06
2018
revised:
02
08
2018
accepted:
24
08
2018
pmc-release:
01
05
2024
medline:
19
4
2023
pubmed:
19
9
2018
entrez:
19
9
2018
Statut:
ppublish
Résumé
Nonphysician practitioners (NPPS), including nurse practitioners (NPs) and physician assistants (PAs) are expanding their scope of practice outside of primary care and performing more procedures in dermatology. To understand the scope and geographic pattern of practice by NPs and PAs in dermatology in the United States. 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 United States. Over 4 million procedures were billed independently by NPs and PAs, which accounted for 11.51% of all procedures. Injection, simple repair, and biopsy were the most commonly billed by the nonphysician practitioners, but complex procedures were also increasingly billed independently by NPs and PAs. Proportions of their claims are higher on the East Coast, Midwest, and Mountain states. Data were collected at the state level and limited to Medicare beneficiaries, and did not include billing incident to physicians. This study demonstrated the increasing scope of practice of NPs and PAs in dermatology; this increase is alarming because of their limited training and the lack of uniform regulations guiding their practices. To ensure quality and safety of care, it is prudent to set benchmarks for proper supervision and utilization of procedures in dermatology.
Sections du résumé
BACKGROUND
Nonphysician practitioners (NPPS), including nurse practitioners (NPs) and physician assistants (PAs) are expanding their scope of practice outside of primary care and performing more procedures in dermatology.
OBJECTIVE
To understand the scope and geographic pattern of practice by NPs and PAs in dermatology in the United States.
METHODS
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 United States.
RESULTS
Over 4 million procedures were billed independently by NPs and PAs, which accounted for 11.51% of all procedures. Injection, simple repair, and biopsy were the most commonly billed by the nonphysician practitioners, but complex procedures were also increasingly billed independently by NPs and PAs. Proportions of their claims are higher on the East Coast, Midwest, and Mountain states.
LIMITATIONS
Data were collected at the state level and limited to Medicare beneficiaries, and did not include billing incident to physicians.
CONCLUSIONS
This study demonstrated the increasing scope of practice of NPs and PAs in dermatology; this increase is alarming because of their limited training and the lack of uniform regulations guiding their practices. To ensure quality and safety of care, it is prudent to set benchmarks for proper supervision and utilization of procedures in dermatology.
Identifiants
pubmed: 30227192
pii: S0190-9622(18)32574-X
doi: 10.1016/j.jaad.2018.08.047
pmc: PMC10599153
mid: NIHMS1884504
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e203-e209Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NIBIB NIH HHS
ID : R01 EB020029
Pays : United States
Organisme : NCI NIH HHS
ID : R44 CA162561
Pays : United States
Informations de copyright
Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
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