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Billing for ILRs implanted by NPs

  • 1.  Billing for ILRs implanted by NPs

    Posted 10-05-2023 12:21
    Edited by Ms. Jamie Harris, APRN 10-05-2023 12:22

    Hello AP colleagues,

    We are working toward ILR implants (in the cath lab/procedural area) by our NPs. The credentialing piece has been addressed in other threads, but does anyone have specific guidance on how you bill for the procedure?

    Specifically, are other programs billing under MD NPIs, or billing under the NPI of the nurse practitioner (and being reimbursed successfully)?

    We are a full-practice authority state in Massachusetts, but NPs independently billing procedures is new to our institution.

    I would love to connect with an NP who has navigated this - I have spoken to my local PA colleagues, but there are some differences in PA vs. NP billing.

    Feel free to email me if preferred at jamie.harris@cardio.chboston.org.

    Thank you for any advice.

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    Jamie Harris APRN
    Nurse Practitioner
    Boston Children`s Hospital
    Boston MA
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  • 2.  RE: Billing for ILRs implanted by NPs

    Posted 11-08-2023 10:04

    Hi Jamie -

    I'm also interested in this, as we are also navigating this process.  We are currently in the credentialing approval process, but I also wonder about payers and how to bill.  Has anyone had denials because an APP has done the procedure and insurance only pays if physician implant?  Or does the physician supervision component (in another EP lab at the time - but available for help) allow us to bill under physician?. My billing folks have not navigated this in the EP space, so I would love to hear what has happened at places where ILRS are routinely implanted by APPs. 

    Thanks!  Jill



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    Jill Schaeffer MSN, CRNP, FHRS, CEPS, CCDS
    Electrophysiology NP
    Penn Medicine Lancaster General Health - The Heart Group
    Lancaster PA
    717-917-6002
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