![]() ![]() ![]() This description does not recognize the CNS role as an advanced practice role or cover our competencies in the nursing or systems spheres of impact. May advise patients on health maintenance and disease prevention or provide case management. Administer nursing care to ill, injured, convalescent or disabled patients. Hopefully, this may change as more states update legislature to grant CNSs full practice authority with prescriptive privileges.Īssess patient health problems and needs, develop and implement nursing care plans, and maintain medical records. By doing so, a larger percentage of each role is acknowledged in the NPPES system, leading to unique group codes specific to the CRNA, CNM and NP.Īt this time, the CNS is counted under the “Registered Nurse” category (29-1140) and is not identified as a separate advanced practice role. One reason other APRN roles are well represented may be that hiring organizations proactively obtain NPI and DEA numbers and other regulatory items for them as part of the onboarding process, based on these roles’ recognized scope of practice. Currently, CRNAs,CNMs and NPs are identified as unique groups with codes specific to their profession. Bureau of Labor Statistics’ (BLS) Occupational Employment and Wage Statistics (OEWS) categorizes occupation profiles, including registered nurses, based on factors including the NPI number. Department of Health and Human Services, notes, “The lack of an accurate, comprehensive health care workforce database may undermine the ability to monitor policies designed to improve access to care and to intervene when necessary to address barriers to care.” Bindman, University of California, San Francisco and U.S. In his research article for Medicare and Medicaid, Andrew B. While the CNS is truly comfortable from the bedside to the boardroom, the majority of us lack the national recognition that an NPI number provides. We demonstrate the value of nursing practice at the system level as an influencer of change - facilitating quality, cost-effective patient outcomes while advocating for the profession of nursing. The multifaceted CNS not only provides expert direct clinical care to patients but works to advance nursing practice through evidence and research. At this time, approximately only 11% of CNSs have an NPI number, which implies that we are rarely, if ever, billing for our services. In 1997, Congress passed the Balanced Budget Act, recognizing the unique role of the CNS in our healthcare system and enabling CNSs to directly bill for services through CMS Part B participation in Medicare. The Centers for Medicare and Medicaid Services (CMS) developed the National Plan and Provider Enumeration System (NPPES) to assign these unique identifiers to providers. This number is called the National Provider Identifier (NPI). ![]() In 1996, the Health Insurance Portability and Accountability Act (HIPAA) mandated that all healthcare providers use a unique 10-digit identification number in all administrative and financial transactions. With almost 90,000 CNSs currently practicing in the U.S., why do only approximately 10,000 have a National Provider Identifier (NPI)? What is the National Provider Identifier? ![]() Nurse practitioners (NPs) account for approximately 69%, nurse anesthetists (CRNAs) for 9% and certified nurse midwives (CNMs) for 2%.Įven after 60+ years of providing safe, evidence-based, quality care, the versatility of the CNS role still remains one of the most underrecognized and underutilized in our healthcare systems. Clinical Nurse Specialists (CNSs) are the second largest group of advanced practice registered nurses (APRNs) in the United States, accounting for approximately 20% of all APRNs. ![]()
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