What are the billing criteria for APRN reimbursement?
Unfortunately, there is not one set of billing criteria or requirements that all third party payors use for either type of reimbursement for services provided by APRNs. Third party payors vary substantially; therefore, it is critical that all APRNs understand the basics of reimbursement and the specifics of how claims are being submitted to all payors for services they provide. A good place to start is with Medicare because it has the most defined criteria that must be followed.
