The Balanced Budget Act of 1997: Reimbursement and the Advanced Practice Nurse

William J. Mazzocco Jr.


January 28, 2000

In This Article


All advanced practice nurses (APNs) who see Medicare patients must make certain they are following the new rules and regulations that evolved from the Balanced Budget Act of 1997. The costs of not knowing are very high and have both personal and professional ramifications.

Numerous articles have been written describing the nonphysician practitioner component of the Balanced Budget Act of 1997.[1,2] The American Academy of Nurse Practitioners also offers detailed guidance about Medicare regulations for APNs.

This one Congressional decision has done more to influence the course of advanced practice nursing than has any other single piece of legislation. Most practitioners are familiar with the statements made in the act, but the ramifications of those statements may not be obvious. Failure to understand what these changes actually mean can only lead to confusion for the neophyte provider about reimbursement and legal issues.


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