Medicare Benefit Policy Manual (Pub. 100-02), Ch. 8 § 50.1
Nursing Care Provided by or Under the Supervision of a
50.1 - Nursing Care Provided by or Under the Supervision of a
Registered Professional Nurse
(Rev. 1, 10-01-03)
A3-3133.1, SNF-230.1
Nursing care provided by or under the supervision of a registered professional nurse is
covered.
However, the services of a private-duty nurse or other private-duty attendant are not
covered. Private-duty nurses or private-duty attendants are registered professional
nurses, licensed practical nurses, or any other trained attendant whose services ordinarily
are rendered to, and restricted to, a particular patient by arrangement between the patient
and the private-duty nurse or attendant. Such persons are engaged or paid by an
individual patient or by someone acting on their behalf, including a SNF that initially
incurs the cost and looks to the patient for payment for such noncovered services.
Where the SNF acts on behalf of a patient, the services of the private-duty nurse or other
attendant under such an arrangement are not extended care services regardless of the
control which the SNF may exercise with respect to the services rendered by such
private-duty nurse or attendant.