The paper work for AP’s in Missouri is moving forward. Below is the Rational for Request for the Health Care Provider Taxonomy Code Request Form. This is to add a new classification into the NPI numbers for Assistant Physicians.
This will reduce confusion on applying and to make paperwork easier for the insurance companies and the pharmacists.
The request will be sent in soon.
If you click here, it shows the health code taxonomy. As you can see, we are absent. I am suggesting to the NUCC that we be added. The proposed change is to change the name of the category of “Physician Assistants & Advanced Practice Nursing Providers” to include “Assistant Physicians”. After this, Assistant Physicians can have a sub category and the different specialties can be categorized below that.
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Rationale for Request
Enter a description of the business need for the request. Please include specific examples of
how the provider is impacted by not having a code.
A new taxonomy is needed to identify Assistant/Associate Physicians.
In the last few years, states have been issuing new medical licenses in an effort to deal with the
shortage of healthcare providers. For example, in the state of Missouri, senate bills 716 and 754
contain language calling on the Missouri Board of Healing Arts to license “assistant physicians”,
medical school graduates who have not yet completed a residency. Similar legislation is or has
been occurring in GA, VA, AR, UT, KS, OK, WA, and NH, as well. However, what we have not seen
to date is a new taxonomy for these prescribers and, as a result, we’re seeing many of these
prescribers’ NPIs being enumerated with taxonomies such as Family Medicine, Internal
Medicine, Physician Assistant, and General Practice, which are not accurate. They should have
their own taxonomy to properly identify them, similar to the taxonomy for residents/interns
(Student in an Organized Health Care Education/Training Program).
With these inaccurate taxonomies, industry stakeholders are not able to appropriately perform
prescriptive authority validations. A proper taxonomy for this new provider type is needed to
allow pharmacies, PBMs, and payers (e.g., State Medicaid agencies) to determine if the
prescriber should be practicing under a supervising physician, can prescribe controlled
substances, or are eligible to enroll with Medicare and/or Medicaid programs in order to comply
with state and federal regulatory requirements.
Additional Information for the Request
Enter any additional information to support the request.
Version 5
12/2016
7
The DEA has also recognized the categorization of assistant physicians and has created a new
business activity subcode (BASC = J) to identify these prescribers. It should be noted that the DEA
is categorizing these prescribers as mid-level practitioners with a business activity code of ‘M’.
For additional information, please refer to page 3 of the “DEA REGISTRATION RECORD LAYOUT”
(https://dea.ntis.gov/recordlayout.pdf).
Proposed Definition
Enter the proposed definition for the code. New code requests must include a definition.
An individual who has completed medical school, is nationally ECFMG/ACGME Certified, and
provides patient care services under the supervision of a physician as part of a collaborative
practice agreement. The methods of treatment and the authority to administer, dispense, or
prescribe drugs delegated in a collaborative practice arrangement between a collaborating
physician and collaborating assistant physician shall be within the scope of practice of each
professional and shall be consistent with each professional’s skill, training, education,
competence, licensure, and/or certification. This taxonomy is not to be confused with “Physician
Assistant.”
Definition source
Enter the source for the proposed definition for the code.
Assistantphysicianassociation.com
Proposed Placement in the Code Set
Enter the proposed placement in the code set, e.g., Level III under Allopathic and Osteopathic
Physicians - Internal Medicine.
Level II under Other Service Providers or Level II under Student, Health Care or Level II under
Physician Assistants and Advanced Practice Nursing Providers