http://community.advanceweb.com/forums/19/ShowForum.aspxenCommunityServer 2.1 SP2 (Debug Build: 61120.2)http://community.advanceweb.com/forums/thread/36896.aspxSun, 22 Mar 2009 00:00:53 GMT06d5312c-37b9-406e-be84-460d8d21f4fc:36896Gera0http://community.advanceweb.com/forums/thread/36896.aspxhttp://community.advanceweb.com/forums/commentrss.aspx?SectionID=19&PostID=36896An RN can that has been certified and trained to administer and supervise administration of chemotherapy. A nurse practitioner is an RN, if trained and certified it would stand to reason they could supervise this activity. In the practice I worked for a physician, NP, or PA needed to be in the office in case of a reaction, not really to supervise that chemo administration. Supervision of staff giving meds as ordered by the oncologist is not a billable activity in and of itself. The 'administration fee or cost' is incorporated in the length and complexity of the visit. An office visit with an RN for chemotherapy was always billed as a level 1. I do not think there is a way to bill for supervision of chemotherapy legally, the insurance company is not going to pay for the safety practice of having an MD,NP, or PA being present. If the patient sees the MD,NP,PA before chemo the charges are expected to be bundled(if I remember correctly). We always had the patient see the practitioner the before chemo and then make a second visit to the office for chemo administration. I think they did this to maximize reimbursement, ensure staffing, and eliminating clogging of the chemo room as many cycled at the same time in their chemo regimes. I know this does not answer your question really, maybe you could find info on the medicare billing site, but I do not think it is a billable service as it is a safety practice.http://community.advanceweb.com/forums/thread/36686.aspxMon, 16 Mar 2009 14:30:25 GMT06d5312c-37b9-406e-be84-460d8d21f4fc:36686Tricia Katzberg0http://community.advanceweb.com/forums/thread/36686.aspxhttp://community.advanceweb.com/forums/commentrss.aspx?SectionID=19&PostID=36686I am a coder at an oncology clinic.  Is it within the scope of practice/licensure of most states for a nurse practioner to supervise chemotherapy without a physician in the building?  Typically I have billed a NP services 'incident to' a physician, but now this has come up and I have not found a satisfactory answer.  I realize NPs do not always have to bill 'incident to', but the chemo supervision is a situation that has not come up before.