NPs and PAs have very limited training and medicine is extremely complex. Things that appear benign may actually be significant.
By limiting NP and PA billing to 99212 and 99213, this will REDUCE COSTS and force NPs and PAs to practice within their intended scope (therefore this is a patient safety issue as well). Any attempts at billing higher mist require direct supervision by a physician as is done with residents (the attending physically sees the patient after the patient is seen by the resident and discussed with the attending) in order to be reimbursed by insurance.
All new evaluations of undifferentiated patients must be seen by a board certified physician first yo reduce the risk of misdiagnoses and subsequent mismanagement. Only after a diagnosis has been established and a treatment plan formulated by the physician can they then be transferred to the NP or PA.
I used to work in the Book Printing and Binding industry as a Quality Control Manager before I retired and we printed the ICD-10 Coding Books along with other medical books. These numbers are just guesses (estimates) but before Obama care there was maybe 2000 codes, but after there were well over 20,000. It went from 1 reasonable book to a 3 volume set, and a new career was created, Medical Coder with training, a certification test and professional license.
Per Wikipedia - The International Statistical Classification of Diseases and Related Health Problems 10th Revision (IDC-10) is list of codes that classify diseases and medical problems. The ICD is published by the [World Health Organization].
Midlevels have strong lobbying, always done under the guise of “expanding access to care.” People don’t realize NPs for example have <5% of the training of an MD/DO. The quality of that training is significantly different too. It’s a huge problem leading people to getting misdiagnosed and subsequently mismanaged (or mismanaged even if the diagnosis is correct).
The most egregious is psych NPs and PAs billing therapy codes (most commonly the add on code 90833) while never having done any therapy training. Now that is legalized fraud. Psychiatrists, psychologists, therapists, etc on the other hand get hundreds to thousands of hours of supervised therapy training.
