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Clinical Staff vs Healthcare Professional

February 5th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Categories:   CPT® Coding  
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State scope of practice laws and regulations will help determine who is considered Clinical staff and Other qualified Health Care professionals. 

Physician or other qualified healthcare professionals:  Must have a State license, education training showing qualifications as well as facility privileges. 

Examples of Qualified Healthcare professionals:

(NOTE: this list is not all-inclusive, please refer to your payer with more specific questions) 

Clinical Staff: The clinical staff member would generally work under the supervision of a physician or perhaps another qualified health care professional.  Clinical Staff must be allowed by regulation, law, and the policy of the facility to perform or assist and will not report their service.  (This is not all inclusive.)

CMS clarifies Clinical Staff with their FAQs Read the entire article here

AAPC also has an article that Defines a Qualified Healthcare Professional.

Read AMA's Physician assistant scope of practice at the state level. 

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