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Advocate Seeks Full Reimbursement for Nurse Practitioners

Analysis  |  By Carol Davis  
   June 18, 2021

NPs have proven their care is on par with physician care, Penn Nursing educator says.

Nurse practitioner Medicare reimbursement rates should be bumped up from 85% of the physician pay rate to the full 100% because of their proven ability to provide comparable care, says a new article in The Online Journal of Issues in Nursing.

Payment parity is essential as nearly half of states have granted full practice authority to NPs and even more have loosened practice restrictions due to COVID-19, says Alycia Bischof, MSN, APRN, PNP-BC, senior lecturer at the University of Pennsylvania School of Nursing (Penn Nursing), who co-authored the article with Sherry A. Greenberg, PhD, RN, GNP-BC, FGSA, FAANP, FAAN, of Seton Hall University College of Nursing.

"The COVID- 19 pandemic serendipitously led to the removal of many restrictions on NP practice, a positive change that needs to become permanent," Bischof says. "This is the time for NPs to seize the opportunity to work with MedPAC to achieve full reimbursement for care provided."

The article, Post COVID-19 Reimbursement Parity for Nurse Practitioners, summarizes the evolution of the practice of NPs and the rationale for reimbursement parity for nurse practitioners. She also outlines the potential benefits of providing NPs with 100% reimbursement, including incentivizing them to practice in primary care settings where there is a shortage.

Support for full practice authority is growing. The National Academy of Medicine released The Future of Nursing 2020-2030 report last month recommending that nurses be allowed to "practice to the full extent of their education and training by removing barriers that prevent them from more fully addressing social needs and social determinants of health and improving health care access, quality, and value."

The report also suggests that federal authority should be used to supersede restrictive scope of practice state laws, the report says.

The American Medical Association and other physician groups, however, argue collaborations are needed for patient safety.

Bischof encourages nurse advocacy groups and researchers to direct future studies to investigate how full practice authority and the removal of practice barriers due to the COVID-19 pandemic have affected the level of care that NPs provide.

"Such studies can then be used to support further evolution of reimbursement policy" she says, "if NPs indeed produce an equal or better product than physicians."

“This is the time for NPs to seize the opportunity to work with MedPAC to achieve full reimbursement for care provided.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.


Nearly half of states have granted full practice authority to NPs, so payment parity is essential, author says.

NPs' Medicare reimbursement rate is 85% of the physician pay rate.

The AMA and other physician groups argue patient safety requires collaboration with NPs.

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