Unfortunately, CMS did not change the reimbursement rate. Nursing Economics, 2007, 25:2, 8184. Almost 90% of NPs are certified in primary care and 69% actually provide primary care. By clicking "Allow All" you agree to the storing of cookies on your device to enhance site navigation, Must be a registered professional nurse authorized by the state in which services are furnished to practice as a NP in accordance with state law and meet one of the following, Obtained Medicare billing privileges as a NP for the first time on or after January 1, 2003 and, Is certified as a NP by a recognized national certifying body that has established standards for NPs and. She is a member of the Gerontology & Geriatrics Education Editorial Board and a peer reviewer for multiple journals. Partin B (2009). Centers for Medicare & Medicaid Services (CMS). Please enable scripts and reload this page. In the hospital inpatient, outpatient and Emergency Department (ED) setting encounters shared between a physician and an APRN from the same group practice, when the physician provides any face-to-face portion of the encounter, report using either provider's NPI. Private health insurance regulations and Any Willing Provider laws vary from state to state but in general do little to facilitate the ability of APRNs to be reimbursed for their services or to be credentialed as PCPs. According to AANP (2020), as of February 2020, there are over 290,000 licensed NPs in the United States (US). 5. When an E&M is shared between a physician and APRN from the same group practice and the physician provides any face to face portion of the E&M encounter with the patient, the service may be billed under the physician's or the APRN's NPI number. Split/Shared Services are an encounter where a Physician and a NPP each personally perform a portion of the E&M visit. Family Practice Management, 22(2), 15-17. The Level I and Level II CPT books available from the AMA lists average time guidelines for a variety of E&M services. Pub. Certain procedures can only be performed by a physician and need referral for those specialized medical procedures (MedPAC, 2002). Medicare information for advanced practice nurses and physician assistants, 2010. More than 36,000 new NPs completed their academic programs in 2020-2021. Retrieved June 3, 2010, from. For instance, if being named jointly with an employer in a lawsuit, the employer can argue that facility's procedures were not followed to the letter. For example, if the annual practice premium costs $10,000 during the last year of coverage, the tail coverage could cost $15,000 to $20,000. Alycia Bischof is a lecturer at the University of Pennsylvania School of Nursing. Then it also varies by state and region. Retrieved from: http://www.medpac.gov/docs/default-source/payment-basics/medpac_payment_basics_19_physician_final_sec.pdf?sfvrsn=0, Medicare Payment Advisory Commission (MedPAC). Citation: Bischof, A., Greenberg, S.A., (May 31, 2021) "Post COVID-19 Reimbursement Parity for Nurse Practitioners" OJIN: The Online Journal of Issues in Nursing Vol. The Medicare programs are administered by the Center for Medicare and Medicaid Services (CMS). With the second method, Medicare, the nursing practitioner receives 80% of the fee that is set by the practice. The diagnosis and treatment codes reported on the health insurance claim form or billing statement should be supported by the documentation on the medical record. Understanding the key concepts of APRN definition, Medicare billing regulations, other insurance's regulations, credentialing for privileges in the health care setting, inpatient versus outpatient billing issues, the use of CPT codes, and other topics as defined by the specific setting in which the APRN works is critical for success. Retrieved from: http://www.medpac.gov/docs/default-source/reports/jun02_NonPhysPay.pdf?sfvrsn=0, Medicare Payment Advisory Commission (MedPAC). In an article in The Online Journal of Issues in Nursing, Alycia Bischof, MSN, APRN, PNP-BC, Senior Lecturer at the University of Pennsylvania School of Nursing (Penn Nursing), argues that given the increased role of NPs (particularly during the pandemic) and their proven ability to provide care comparable to physicians, Congress should allow Medicare to increase the NP reimbursement rate to 100% of the physician pay rate. Dr. Greenberg is a Fellow in the American Academy of Nursing, American Association of Nurse Practitioners, Gerontological Society of America, and New York Academy of Medicine, as well as Distinguished Educator in Gerontological Nursing through the National Hartford Center of Gerontological Nursing Excellence. 2011. The role of the NP has expanded in the last two decades. Dr. Greenberg has worked as a certified gerontological nurse practitioner in acute, long-term care, and outpatient primary care practices and has taught at undergraduate and graduate nursing levels. Research has shown that NPs provide quality, cost effective care with a favorable patient experience (Kippenbrock et al., 2019) (See Table 1). These studies must further explore the effect that NPs have on healthcare today. NPs provide quality, cost effective care (Barnes et al., 2016; Kippenbrock et al., 2019; Naylor & Kurtzman, 2010). CMS bases physician payment on a formula that includes relative value units (RVUs). Reimbursement parity will make it easier for NPs to meet the growing need for primary care providers. Additional and more rigorous research is needed. Evaluation and Management Services refer to visits and consultations furnished by providers. (List separately in addition to code for primary procedure; CPT Codebook 2011.). 3. This becomes even more important if Congress chooses to accept MedPACs recommendation and eliminate incident to billing. With MedPAC as the organization tasked with advising Congress about best practices for Medicare, action steps to increase reimbursement need to focus on MedPAC buy-in that NPs produce the same product as physicians. Reducing COVID-19 burden: could Bacille Calmette-Gurin (BCG) vaccines confer protection? Evaluation and Management Services Part B. NPs now run rural health clinics, nurse managed centers and retail clinics (Hansen-Turton et al., 2010). Most NPs are trained in primary care and often provide care to an underserved population. 26, No. In this episode of omg OMx, Bruker's science-driven podcast, Kate Stumpo interviews Daniel Hornburg, the VP of Proteomics at Seer, as they discuss the innovative technologies in plasma proteomics. Because visits that are billed incident to are reimbursed at 100%, and visits billed under an NP provider number are billed at 85%, Medicare would save a substantial amount of money by eliminating incident to billing. The service must be within the APRN's scope of practice under state law. E&M codes will have to suffice at this time. Primary Care Providers by the NumbersThe Affordable Care Act (2010), which President Obama signed into law in 2010, provided access to healthcare for millions of uninsured Americans. Researchers need to investigate how full practice authority, and the removal of practice barriers due to the COVID-19 pandemic, have affected the level of care that NPs provide. This paper will utilize the term advanced practice nurse to only include the clinical nurse specialist and the nurse practitioner. Nurse-managed health centers and retail clinics that are run and managed by NPs are expanding.Barnes, Aiken and Villaruel (2016) reviewed over 40 years of studies that all support the quality and safety of NP care. Medicare: Federal health insurance program for the elderly and disabled. Optimize revenue and improve patient outcomes with Medicare's Annual Wellness Visits. Retrieved from: https://www.govinfo.gov/content/pkg/STATUTE-91/pdf/STATUTE-91-Pg1485.pdf, U. S. Congress. (2018, March 19). (2002). What are the benefits of exercise on cardiovascular health. See the 2021 rate information. (2021). From nanoparticle-based enrichment to mass spec refinements, they explore how these tools facilitate unbiased, deep, and rapid proteomics. Those interested in pursuing a career as a family NP can explore the following . These studies demonstrated outcomes comparable to, and sometimes better than, physicians. NPs are doing much of the same work as their physician colleagues (Sullivan-Marx, 2008); therefore, they should receive the same reimbursement. The American Nurses Association (ANA) has advocated that all advance practice nurses have one title of Advance Practice Registered Nurse (APRN). The provider can be a physician, nurse practitioner, clinical nurse specialist, physician's assistant, nurse midwife, and clinical psychologist. 2. Either version may be used (but not both) by the provider for a patient encounter. However, there are exceptions to this statement. This information is used by Medicare to provide reimbursement, collect statistics, and make future decisions upon reimbursement. (2010). NPs are generally paid higher salaries in specialties than in primary care. Employment relationships affect who has the right to bill for an APRN's services. The American Academy of Nurse Practitioners. A clear regulatory framework and payment . 10am - 8pm. The history of APRN reimbursement is important to understand as it provides context to what follows. If an APRN changes a dose of digoxin based on the laboratory results from earlier in the day, it is considered a provider service (medical decision-making). Diligence is required in selection of the appropriate code for services rendered since the code reported dictates the amount of reimbursement. Given the increased role of NPs, and their ability to provide care comparable to physicians, Congress should allow Medicare to increase the NP reimbursement rate to equate to 100% of the physician pay rate. The number of Evaluation & Management (E/M) visits by NPs increased from 11 million to 31 million, while the number of visits billed by physicians decreased by 16%. Is there an association between post COVID-19 syndrome and cognitive impairment? 17. To maximize the utilization of APRNs as PCPs, the payment system should be remodeled. Your message has been successfully sent to your colleague. Retrieved from: https://www.congress.gov/bill/101st-congress/house-bill/5835, U. S. Congress. - Montana's unemployment rate reached yet another all-time low in March, ticking down to 2.3% from 2.4% in February, the fourth lowest rate in the nation. Both of these reasons illustrate why payment parity is essential. Example: A physician sees a patient in their office and bills Medicare for that office visit. As the APRN determines his/her practice site preference, he/she will need to investigate levels of minimal as well as maximal coverage for their practice, which is generally based on risk association for the type practice (some areas of practice have higher litigious rates and therefore higher premiums). Information: www.cms.gov/nationalprovidentstand/. So, if a physician provides services to a patient Medicare deems worthy of a $100 reimbursement, the NP would be reimbursed $85 for providing the same care ( there are ways to get around this ). doi: 10.1097/MLR.0000000000000406, Medicare Payment Advisory Commission (MedPAC). Dr. Greenberg currently serves as President-Elect on the Board of Directors of the Gerontological Advanced Practice Nurses Association and as a member of the Jonas Scholars Alumni Council. your express consent. When performing debridement of a single wound, report depth using the deepest level of tissue removed. COVID-19 brings changes to NP scope of practice. Health care facilities set their own guidelines regarding how often a provider is re-credentialed to maintain their status. Recognition of this productivity by both parties is crucial for NPPs to receive parity for equal services.A study conducted by the RAND corporation found that the average cost of an NP visit was 20-35% lower than that of a physician visit (Naylor & Kurtamam, 2010). She received a BSN and MSN from the University of Pennsylvania School of Nursing. The Nurse Practitioner: The America Journal of Primary Health Care, : 35:11, 2447. News-Medical.Net provides this medical information service in accordance It was determined that there was no justification as to why CNMs should be reimbursed less than NPs or PAs (MedPAC, 2002). Balanced Budget Act of 1997, Pub. Third, the care must be rendered under the direct supervision of the physician. 101-508, 104 Stat. ISSN: 1091-3734 American Nurses Association - 8515 Georgia Avenue - Suite 400 - Silver Spring, MD 20910, Sherry A. Greenberg, PhD, RN, GNP-BC, FGSA, FAANP, FAAN, Patricia Pittman, PhD, FAAN; Jeongyoung Park, PhD, Linda Millenbach, Ph.D, RN; Frances E. Crosby, Ed.D, RN; Jerome Niyirora, Ph.D, MS, RHIA; Kathleen Sellers, PhD, RN; Rhonda Maneval, DEd, RN; Jen Pettis, MS, RN, CNE, WCC; Noreen B. Brennan, PhD, RN-BC, NEA-BC; Mary Anne Gallagher, DNP, RN, Ped-BC; Nancy Michela, DAHS, MS, RN; Deborah Elliott, MBA, BSN, RN, Chad Rittle DNP, MPH, RN FAAOHN; Lora Walter, DNP, RNC-NIC, Garrett K. Chan, PhD, APRN, FAEN, FPCN, FCNS, FNAP, FAAN; Jana R. Bitton, MPA; Richard L. Allgeyer, PhD; Deborah Elliott, MBA, BSN, RN; Laura R. Hudson, MSN, RN; Patricia Moulton Burwell, PhD, Catherine A. Grano, MSN, RN, CSN-NJ; Eileen M. Gavin, MSN, FNP-BC, NCSN; Robin Cogan, MEd, RN, NCSN, Lakisha D. Flagg, DrPH, RN, PHNA-BC; Lisa A. Campbell, DNP, RN, PHNA-BC, FAAN, Francine H. Sheppard, PhD, RN, CNE, CDP; R. Turner Goins, PhD; Ratchneewan Ross, PhD, RN, FAAN; Kathleen Conte, PhD; Nicole Zonin, MSN, RN, Andrew R. Benson, DNP, MSN, CRNA, FAAN; Jessica S. Peters, DNP, MS, RN, ACNP-BC; Colleen Kennedy, DNP, CNM; Michelle Patch, PhD, MSN, APRN-CNS, ACNS-BC, Blima Marcus, DNP, RN, ANP-BC, OCN; Lindsey H. Danielson, MS, FNP-C; Tamar Y. Frenkel, BSN, RN, Post COVID-19 Reimbursement Parity for Nurse Practitioners. If not charted, the rationale for ordering diagnostic and other ancillary services should be easily inferred. Journal of Wound, Ostomy and Continence Nursing, Get new journal Tables of Contents sent right to your email inbox, http://www.gpo.gov/fdsys/pkg/PLAW-105publ33/pdf/PLAW-105publ33.pdf, http://www.medscape.org/viewarticle/562664_print, http://www.medscape.com/viewarticle/531035, https://www.ncsbn.org/Consensus_Model_for_APRN_Regulation_July_2008.pdf, http://www.cms.gov/MLNProducts/downloads/Medicare_Information_for_APNs_and_PAs_Booklet_ICN901623.pdf, http://www.cms.gov/manuals/downloads/pim83c15.pdf, https://www.cms.gov/MedicareProviderSupEnroll/, http://edocket.access.gpo.gov/cfr_2005/octqtr/pdf/42cfr410.21.pdf, https://www.cms.gov/manuals/downloads/clm104c01.pdf, http://www.cms.gov/MLNProducts/Downloads/1995dg.pdf, http://www.cms.gov/MLNProducts/Downloads/MASTER1.pdf, http://www.trailblazerhealth.com/Publications/Training%20Manual/EvaluationandManagementServices.pdf, http://www.cms.gov/MLNProducts/downloads/eval_mgmt_serv_guide.pdf, http://www.cms.gov/MLNEdWebGuide/25_EMDOC.asp, http://www.cnaptexas.org/displaycommon.cfm?an=1&subarticlenbr=17, http://www.ispub.com/journal/the_internet_journal_of_advanced_nursing_practice/volume_9_number_1_3/article/advanced_practice_nursing_constraints_to_role_fulfillment.html, Reimbursement of Advanced Practice Registered Nurse Services: A Fact Sheet, Understanding Medicare Part B Incident To Billing: A Fact Sheet, Ankle Brachial Index: Quick Reference Guide for Clinicians, Introduction to Reimbursement of Advanced Practice Registered Nurse Services and Understanding Medicare Part B Incident to Billing, The CAUTI Prevention Tool Kit: A Professional Practice and Collaborative Project of the Wound, Ostomy and Continence Nurses Society, 2021 Guideline for Management of Patients With Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease: An Executive Summary, Privacy Policy (Updated December 15, 2022), by the Wound, Ostomy and Continence Nurses Society. Figure. Retrieved from: https://www.aafp.org/fpm/2015/0300/p15.html, Sullivan-Marx, E. M. (2008). Number of nurse practitioners hits new record high. Personal Injury Coverage. Frequently asked questions about professional liability insurance of NPs, 2011. Meta-analysis shows phytosterol-fortified foods effectively lower LDL cholesterol levels. 111-148, 124 Stat. The provider must initiate a course of treatment and the services done by the auxiliary staff include follow up care, and assisting in the plan of care. In June 2019, MedPAC again addressed payment policies for NPs and PAs. HealthLeaders. The following two examples are provided as a guide in using the CPT codebook.11, Wound debridement (codes: 11042-11047) is reported by the depth of tissue that is removed and by the surface area of the wound. There are numerous factors that contribute to the risk for being named in a lawsuit, among them are patient load, voluminous paperwork associated with care provided, and staffing shortages. Policy, Politics, & Nursing Practice, 9(2), 121-126. doi: 10.1177%2F1527154408318098, U. S. Congress. The services must meet the definition of the code. Thus, NPs offer an ideal solution to the primary care provider shortage. APRNs should question their actual or potential employer about the policy carried to cover them as employees. Hospitals planning to bill Medicaid, may query state Medicaid and commercial payers about their rules and policies.2. Either the service can be billed under the APRN and receive 85% of the physician's scheduled rate or the service can be billed under the physician's number and receive 100% of the physician's rate.10 If the APRN and the physician are employed by different groups and both groups submit bills, the second bill to arrive at the payer's office will be denied. Interestingly, they also reconsidered incident to billing and decided to continue reimbursing NPPs at 100% if they submitted the bill as incident to (MedPAC, 2002). Using Medicare" Incident-to" rules. Reimbursement for Nurse Practitioner Services Reimbursement for Nurse Practitioner Services Except for a minority of patients who pay their own medical bills, every encounter between an NP and a patient has a third-party participantthe payer. Therefore, it is difficult for payers and the public to recognize the productivity of the NPP (Medicare Payment Advisory Commission [MedPAC], 2019a) (See Table 1). Studies have supported this NP care as cost-effective. In multiple wounds, sum the surface area of those wounds that are at the same depth, but do not combine sums from different depths. Maintaining that argument can devastate the practitioner's career, even if the case is dismissed from court or the practitioner is acquitted of malpractice. Although CMS rules refer to Medicare billing, other insurance companies often base their billing practices on CMS guidelines (Edmunds, 2014). Medicare reimburses 100% for services billed as incident to.. Figure. The employer would retain the right to file a complaint against the practitioner to his/her licensing body (i.e., the state's Board of Nursing). Incident to billing is beyond the scope of this fact sheet; for information on incident to billing, refer to the WOCN Society fact sheet entitled: Understanding Medicare Part B Incident to Billing. (In press, 2011.). The Indian Health Service (IHS) rate is an all-inclusive rate reimbursed to IHS and tribal facilities by CMS for Medicaid-covered services. Add on codes describe additional intra-service work associated with the primary procedure and must be performed by the same provider. The rise in full practice authority states, as well as nurse managed clinics and retail clinics, has led to more NPs practicing independently. International Classification of Disease, Diagnosis, and Procedural Codes (ICD-10): Is a replacement for ICD-9-CM diagnosis and procedure codes. American Association of Nurse Practitioners (AANP). From 2010 2017, the number of NPs who billed Medicare increased by 151%. The American Nurses Credentialing Center. More than 89% of NPs are certified in primary care, yet 69% actually practice in primary care (AANP, 2020). Payment Basics. Residents in these communities were often older adults, minorities, and low-income populations traditionally with significant healthcare needs. 2. There are more than 355,000 nurse practitioners (NPs) licensed in the U.S. 1. Policies may vary from region to region. (2010). Why Should Nurse Practitioners Receive 100% Reimbursement? How does incident to billing affect NP practice? Each state independently determines the APRN legal scope of practice, the roles that are recognized, the criteria for entry-into advanced practice, and the certification examinations accepted for entry-level competence assessment. AANP Positions and Papers. Evaluating the association between Mediterranean Diet adherence and type 2 diabetes using nutritional biomarkers. Congress has not yet acted on their recommendation. This put CNMs on par with the other NPs and PAs. Reimbursement by private insurance companies is separate from the Medicare process and may require a credentialing process. Now is the time for NPs to receive full reimbursement from Medicare. Centers for Medicare & Medicaid Services (CMS). Montana's total employment . Under incident to payment, a non-physician provider (NPP), such as an NP, certified nurse midwife (CNM) or physician assistant (PA), renders the care, but the visit is billed under the physicians name. CMS argues that a disparity exists between physician and NP payment because physicians have higher training cost, they are responsible for the overhead office cost, and they pay higher malpractice premiums. Therefore, NPPs have a choice: bill under their own provider number and receive 85% reimbursement and accurately track NP-specific practice trends and payments or, satisfy the incident to rules and receive 100% reimbursement (Chapman, Wides, & Spetz, 2010). The Nurse Practitioner, 44(2), 15-17. doi: 10.1097/01.npr.0000552680.76769.e5, Shay, D. F. (2015). 10. The report contains information such a facility characteristics, utilization data, cost, and charge by cost center and financial statement data. L. No. Patient satisfaction scores for NPs were high, with millions of patients choosing NPs as their primary care provider. The decrease in reimbursement results in financial instability and decreased employment opportunities, in addition to decreased recognition of the value of NP visits and care (Chapman et al., 2010). Wolters Kluwer Health MedPAC estimated that half of all primary care NPs are billing incident to. If that is eliminated, practices would lose 15% of reimbursement for those visits. (2019a). In 1990, direct APRN reimbursement by Medicare was available only in rural areas and skilled nursing facilities.3 In 1997, Medicare expanded reimbursement for Clinical Nurse Specialists (CNS) and Nurse Practitioners (NP; as well as nurse anesthetists and nurse midwives, however these roles will not be covered in this fact sheet) to all geographical and clinical settings allowing direct Medicare reimbursement to the APRN, but at 85% of the physician rate.1 This success was won because of the powerful political action of the American Nurses Association, utilizing outcome data to show how CNS' and NPs make a difference in cost and quality, and the political action partnerships established with specialty organizations and grassroots actions of local nurses. In addition, an employer's policy does not protect the APRN's license to practice. Even more states have loosened practice restrictions due . Cosmetic Procedures . However, reimbursement is only provided at 85% of the physician rate. It is important to note that in addition to federal billing guidelines, each state has licensing authority for APRNs and this licensing authority can be different depending upon the state in which the APRN practices. Their role in healthcare has also evolved. However, reimbursement for their services has been a journey. Most nurse practitioners are aware that Medicare reimburses nurse practitioners 85% of the physician rate. The Evaluation and Management (E&M) service is the most common service provided by an APRN in the hospital. Medicare will pay only one charge per day, per patient, per specialty, for Evaluation and Management billing. NPs have also increased their role in specialties. Potentially preventable hospitalizations in Medicare patients with diabetes: A comparison of primary care provided by nurse practitioners versus physicians. Consensus model for APRN regulation: Licensure, accreditation, certification & education, 2008. CPT codes are developed, maintained, and copyrighted by the American Medical Association (AMA). Dr. Sherry Greenberg is an Associate Professor at Seton Hall University College of Nursing and a Courtesy-Appointed Associate Professor at New York University Rory Meyers College of Nursing. All rights reserved. In the article, she summarizes the evolution of the practice of NPs and the rationale for reimbursement parity for nurse practitioners. As stated, NPs fill the void in caring for the poor and uninsured, as well as older adults. Report to the Congress: Medicare and the Healthcare Delivery System. The exception is Medicare, which reimburses only 85% of the standard fees for PA-provided care. If the APRN leaves the employment of the facility/agency, does the policy cover for an incident that occurred while still employed (is the employer's policy Occurrence)? She is a PNCB board certified, practicing pediatric nurse practitioner. Over the past decade, the number of NPs has dramatically increased, from 120,000 in 2007 (American Association of Nurse Practitioners [AANP], 2018) to 290,000 in 2019 (AANP, 2020). Medical Care, 53(9), 776783. Thus, it is suggested that each APRN examine the state regulations in the state or states where they will practice.5, The Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education5 has been endorsed by 41 nursing organizations, including the WOCN Society. Bill under the APP's own National Provider Identifier (NPI). The following are the Medicare required APRN coverage criteria:6. However, reimbursement is only provided at 85% of the physician rate. Repeated and frequent use of the code may lead to the development of a CPT for that service/procedure. A national survey of nurse practitioners' patient satisfaction outcomes. Nursing services are reimbursed through prospective payments or payments based on direct Diagnosis Related Groups (DRG). Defense Attorney Provided. In the same 2002 session, MedPAC looked at the justification of the 85% rule. One negative outcome, whether real or perceived by the patient or caregiver, can easily result in a lawsuit. It is important to keep in mind with both the 1995 and 1997 documentation guidelines, that noting an abnormal or unexpected finding in an examination requires further description, whereas a brief statement or notation indicating a negative or normal finding is sufficient for documentation related to unaffected areas or asymptomatic system(s).12,13. Montana's unemployment rate has fallen for four consecutive months, and the number of unemployed Montanans reached an all-time low in March. (2019b). Documentation Guidelines for Evaluation and Management (E/M). Buppert C. Billing for Nurse Practitioner Services-update 2007: Guidelines for NP's, physicians, employers and insurers, Medscape nurses, 2007. Studies have demonstrated that NPs provide the same quality of care as physicians, yet they do not receive the same reimbursement. For a direct reimbursement, a practitioner must undergo an application process conducted by the payer. State laws specify the physician services that APRNs are authorized to perform and each state's definition is slightly different. The role of nurse practitioners in reinventing primary care. The global surgical package is a fixed fee to cover all treatment and services related to the surgical procedure including pre-operative visits after the decision is made to operate beginning with the day before the surgery, intraoperative services, and complications following surgery. 9:2, 2008, 12126. From the desk of the ACNP Health Policy Director. The American Journal of Medicine, 128(8), 800-801. doi: 10.1016/j.amjmed.2015.02.023, Hansen-Turton, T., Bailey, D. N., Torres, N., & Ritter, A.
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