Medicare Benefit Policy Manual (Pub. 100-02), Ch. 13 § 130.1
NP, PA, and CNM Requirements
130.1 - NP, PA, and CNM Requirements
(Rev. 220, Issued: 01-15-16, Effective: 02-01-16, Implementation: 02-01-16)
Services performed by NPs, PAs, and CNMs must be:
• Furnished under the general (or direct, if required by state law) medical
supervision of a physician;
• Furnished in accordance with RHC or FQHC policies and any physician medical
orders for the care and treatment of a patient;
• A type of service which the NP, PA, or CNM who furnished the service is legally
permitted to furnish by the state in which the service is rendered;
• Furnished in accordance with state restrictions as to setting and supervision;
• Furnished in accordance with written RHC or FQHC policies that specify what
services these practitioners may furnish to patients; and
• A type of service which would be covered under Medicare if furnished by a
physician.