Medicare Program Integrity Manual (Pub. 100-08), Ch. 5 § 5.7
Nurse Practitioner or Clinical Nurse Specialist Rules Concerning
5.7 – Nurse Practitioner or Clinical Nurse Specialist Rules Concerning
Orders and CMNs
(Rev. 10190; Issued: 06-19-2020; Effective: 01-01-2020; Implementation: 07-01-
2020)
A nurse practitioner or clinical nurse specialist may give the dispensing order and sign
the detailed written order in the following situations:
•
They are treating the beneficiary for the condition for which the item is needed;
•
They are practicing independently of a physician;
•
They bill Medicare for other covered services using their own provider number;
and
•
They are permitted to do all of the above in the State in which the services are
rendered.
A nurse practitioner or clinical nurse specialist may complete Section B and sign Section
D of a CMN if they meet all the criteria described above for signing orders.