Eligible Professionals

20 – Eligible Professionals (Rev. 10, Issued: 07-27-12, Effective: 10-29-12, Implementation: 10-29-12) As defined in section 1848(k)(3)(B) of the Act, eligible professional means any of the following: 1. Physicians • Doctor of Medicine • Doctor of Osteopathy • Doctor of Podiatric Medicine • Doctor of Optometry • Doctor of Dental Surgery • Doctor of Dental Medicine • Doctor of Chiropractic 2. Practitioners • Physician Assistant • Nurse Practitioner • Clinical Nurse Specialist • Certified Registered Nurse Anesthetist (and Anesthesiologist Assistant) • Certified Nurse Midwife • Clinical Social Worker • Clinical Psychologist • Registered Dietician • Nutrition Professional • Audiologists (as of 1/1/2009) 3. Therapists • Physical Therapist • Occupational Therapist • Qualified Speech-Language Therapist (began billing Medicare directly as of 7/1/09) Audiologists were added to the definition of “eligible professional” beginning with the 2009 Physician Quality Reporting System as required by section 131(b)(4) of the MIPPA. 5 All Medicare-enrolled professionals in these categories are eligible to participate in the Physician Quality Reporting System, regardless of whether the professional has signed a Medicare participation agreement to accept assignment on all claims.