What primarily dictates the NP's authority to bill Medicare for services?

The primary authority for Nurse Practitioners (NPs) to bill Medicare for services is dictated by federal law. Medicare operates under federal regulations, which stipulate the criteria for reimbursement, the scope of practice for healthcare providers, including NPs, and the specific requirements needed for billing procedures. Under federal law, NPs must meet certain qualifications, such as having appropriate credentials and licenses, to be recognized as eligible practitioners who can bill Medicare directly for their provided services.

While state laws do govern the licensure and practice scope of NPs within their specific states, they do not override or change the federal guidelines that dictate billing practices for Medicare. Similarly, private health insurance policies may have different rules and regulations regarding billing and coverage, but those do not pertain specifically to Medicare, which is solely regulated by federal guidelines. Therefore, federal law's influence on billing authority makes it the primary factor in determining NPs' ability to bill Medicare for their services.