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Book Review
Understanding Payment for Advanced Practice Nursing Services,
Volume One: Medicare Reimbursement

Reviewed by Marty Couret MSN, NP

Pub. #: APNS20
List Price: $34.95
Copyright: 2000
Publication Date: 2000
Publisher: American Nurses Association

Sheila Abood MS, RN and David Keepnews JD, MPH, RN, FAAN have done a great job explaining the ins and outs of Medicare in their new book Understanding Payment for Advanced Practice Nursing Services. The book begins by providing and introduction and historical background on Medicare coverage. The chapter on Medicare Law and Policy provides information on federal regulations and carrier instructions. Understanding Payment for Advanced Practice Nursing Services next chapter Making Sense of Medicare Coverage of NP ad CNS Services discusses the "legal authorization to perform part B services." This chapter answers complicated questions such as:

  • Who is considered an NP or a CNS?
  • What does collaboration mean?
  • What does it mean to be legally authorized to perform services?
  • What does the language on "incident to" services mean and where can I find it?
  • What does the language about "only if no facility or other provider charges or is paid" mean?
  • How much will I be reimbursed?
  • What are professional services?
  • How am I reimbursed for mental health services?
  • Can I order tests and services?

The next chapter in Understanding Payment for Advanced Practice Nursing Services takes on enrolling as a Medicare provider. This chapter provides the reader with what they will need to apply, where to get the applications, and even provides sample applications to practice on. Information on group practice billing, changes in provider information, and opting out of the Medicare program are also included in this chapter. Sections on Billing, Claims, and Fraud complete this chapter.

There are several appendixes in Understanding Payment for Advanced Practice Nursing Services. They are as follows:

  • Appendix A: Selected Sections of the Code of Federal Regulations
  • Appendix B: Medicare Forms
  • Appendix C: Medicare Manual Memorandum and Transmittals
  • Appendix D: AMA/HCFA 1997 and 1995 Documentation Guidelines for Evaluation and Management Services
Understanding Payment for Advanced Practice Nursing Services provides the information necessary to fully understand Medicare. It is destined to be a textbook for student nurse practitioners across the country. I highly recommend it to new graduates or anyone trying to figure out the convoluted process of Medicare reimbursement.

If you are interested in ordering this book, please go to the
American Nurses' Association online bookstore!


Updated October 2, 2001


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