The Centers on Medicare and Medicaid Services (CMS) published the 2013 physician fee schedule final rule, authorizing Medicare direct reimbursement of CRNA chronic pain management services, and of all services within CRNA scope of practice in a state where the services are permitted to be furnished.  The agency’s action, which takes effect Jan. 1, 2013, is consistent with the Institute of Medicine’s recommendation that Medicare cover services provided by advanced practice nurses to the full extent of their state scope of practice.

The text below is excerpted from a statement from the American Association of Nurse Anesthetists (AANA). It can be found in its entirety here.

The AANA applauds the Centers for Medicare & Medicaid Services and the Administration for ruling to preserve patient access to chronic pain management services administered by CRNAs – in fact, access to all services within the full scope of CRNA practice. The official language from the ruling can be found here.   Going into effect on January 1, 2013, the highlights of the agency ruling include:

• Expanding Medicare coverage of services within CRNA scope of practice by stating that “Anesthesia and related care means those services that a certified registered nurse anesthetist is legally authorized to perform in that state in which the services are furnished”;
• Agreeing with the AANA and those who submitted comments through the Protect My Pain Care Campaign, whose overarching message was that  the primary responsibility for establishing the scope of services CRNAs are trained for and authorized to furnish resides with the states; and
• Defining the Medicare benefit category for CRNAs as including any services CRNAs are permitted to furnish under their state scope of practice.

What does this mean?  It means that under Medicare, Americans suffering from chronic pain will continue to receive the pain care they need from CRNAs they know and trust.   This ruling is an important development both for patients and for the nation’s 45,000 nurse anesthetists who deliver more than 33 million anesthetics every year and have gone through nationally accredited educational programs at the masters’ or doctoral level. It is consistent with the Institute of Medicine’s recommendation that Medicare cover services provided by advanced practice nurses to the full extent of their state scope of practice. It is especially meaningful for patients in rural and other medically underserved communities. Without local access to pain treatment from CRNAs, many seniors would have to travel long distances to receive care, move into a nursing home, or forego treatment altogether. This federal ruling also respects state scope of practice rules and regulations.