Last Updated 26 Jan 2021

Advanced Nurse Practitioner Reimbursement

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In 2002, the Medicare Payment Advisory Commission (MedPAC) brought before this house a report on the need to implement equal reimbursement strategy across the health sector (Edmunds, 2002). These report aimed at addressing the unbalanced reimbursement practice experienced by NPs, clinical nurse specialists, certified nurse midwives and assistant physicians (Edmunds, 2002).

Essentially, the report recommended that the Medicare payment rates for certified nurse-midwives be raised by 85% of the physician fee schedule (Medicare Payment Advisory Commission, 2002). The congress members overwhelmingly voted positively for this bill (Medicare Payment Advisory Commission, 2002).

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The intent of this statement today is to invite congress members here present to review the said recommendation. In particular, this statement wishes to go an extra mile to assert that Medicare payment rates for advanced practicing nurses (APNs) should not be gauged by the physician’s payment schedule.


The percentage rate reflected in the previous recommendation mentioned above limits the APNs from get what they truly deserve. It is imperative, therefore, to recognize that the role of APNs has evolved tremendously for the better so this nation needs to treat their service with the authenticity it deserves.

Gone are the days when they worked under the supervision of the physicians. Do congress members here present believe that APNs’ role is meant for the physicians’ such that the former serve as their servants? Is it not so that APNs role is meant for the health and safety of many generations to come?

Therefore, their reimbursement process should be dealt with as an end in itself and the agreed payment rates must assume a 100% judgment. This means that they should get reimbursed as per their input; how this house will settle for their just reimbursement should only be guided by the efforts being put by APNs.

This way the members of this house will not only effect a just compensation procedure but they will also recognize the great improvement that has taken place in this nation. Moreover, most Americans continue to benefit from their quality and cost-effective services.

In the past physicians dominated in services like diagnosing illness, describing and interpreting laboratory tests, performing physical check ups, suturing wounds and designing preventive health service programs (Sekscenski et al. 1994). Today, the APNs can provide such services in the absence of the physician.

Please note that this is not because the physician have got lots of other things to do, no; the bottom line is that APNs healthcare practitioners have really grown and improved in skill.

APNs mark a remarkable growing share of the health care provider workforce. It is believed that the number of certified and practicing nurses has risen from approximately 60,000 in 19992 to 124,000 in 2000 (AAPA, 2001). Others in support of this statistics are (Spratley et al. 2000; Moses, 1992). On the contrary the number of active physicians grew by 27%, to 772,000, on the same period (Cooper et al., 2002)

It is important to bring to the attention of this house that the fact that the APNs can handle complicated health matters without the direct supervision of physicians has saved this nation many lives worth much more than the would-be reimbursement.

Even if this house agreed to reimburse the APNs as much money as many cannot imagine, it cannot replace the value of their services and the value of the citizens’ health safety. Additionally, the APNs have a legal duty to practice independently or in association with a physician, therefore, they are entitled to a direct reimbursement.

The report noted that physicians got paid100% of the physician fee schedule rate excluding any differentiation by specialty (Medicare Payment Advisory Commission, 2002). Now all other nonphysician practitioners get remunerated as per the physician schedule.

This without the fear of contradiction implies that physicians enjoy from where they have not labored. Once again, this statement re-states that APNs ought to have an authentic payment schedule and the features to it must be separated from those of the physicians at all times.


Overall, this nation recognizes the good judgments exhibited by the congress members in the many decades ago. The caution and positive consideration they have demonstrated in shaping the history of this nation’s health sector is laudable.

In the same spirit, the APNs fraternity is out there waiting for a positive consideration in this matter. It is important to keep in mind that health matters are very sensitive. It is among those services that must be available to the people no matter the cost.

Therefore, consideration of a better reimbursement as suggested in front of this house will lead to this end. This congress cannot fail to take this matter seriously.

To sum up, this statement invites the congress members here present to consider the following:

  1. Separation of physicians’ roles from those of the Advanced Practicing Nurses (nonphysicians).
  2. Medicare payment rates for advanced practicing nurses (APNs) not to be gauged by the physician’s payment schedule.

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