ADVANCED PRACTICE CERTIFICATION AND SCOPE OF PRACTICE GUIDELINES

The following guidelines serve to inform hiring directors/managers and supervising physicians with the knowledge necessary to make appropriate decisions related to recruitment, candidate selection, and practice site placement of Advanced Practice Providers (APP’s). Key: ANCC – American Nurses Credentialing Center PNCB – Pediatric Nursing Certification Board AMCB – American Midwifery Certification Board NBCRNA – National Board of Certification/Recertification for Nurse Anesthetist NCC – National Certification Corporation NCCPA - National Commission on Certification for Physicians' assistants

CERTIFICATION POTENTIAL PRACTICE SITES INPATIENT CERTIFYING UTILIZATION ENTITY Family Nurse Adult and Ambulatory Ambulatory Walk-in Population & AANP Practitioner pediatric internal subspecialty clinics/Urgent Service ANCC (FNP-BC) Ambulatory medicine chronic Care Dependent primary care clinics disease clinics Pediatric Ambulatory Ambulatory Pediatric Pediatric Population & ANCC Primary Care primary care subspecialty chronic Walk-in Service PNCB (PPCNP-BC) pediatric clinics disease clinics Dependent or clinics clinics (CPNP-PC)

Pediatric Pediatric Pediatric Pediatric Pediatric Yes PNCB Acute Care critical care subspecialty subspecialty Walk in (CPNP-AC) inpatient care care Clinics/Urgent inpatient ambulatory Care

Adult Adult Ambulatory Ambulatory Walk-in Population & ANCC Gerontology Ambulatory internal subspecialty clinics/Urgent Service AAFP Primary Care primary care medicine chronic Care Dependent (AGPCNP-BC) clinics disease clinics or (AGNP-C)

Adult Adult critical Adult Adult Yes ANCC Gerontology care; subspecialty subspecialty Acute Care inpatient care care (AGACNP-BC) inpatient ambulatory

Women’s Inpatient Ambulatory Ambulatory Population & NCC Health OB/GYN OB/GYN women’s Service (WHNP-BC) clinics subspecialty Dependent clinics (breast center, etc) Neonatal NP Neonatal Special Care Normal Neonatal Yes NCC (NNP-BC) Intensive Nurseries Newborn Transport Care (Level 2a-b) programs (Level 3a-c) Primary care or subspecialty chronic disease Certified Ambulatory Community- Hospital- Newborn Yes AMCB Nurse Midwife OB/GYN based based Nurseries (CNM) clinics Birthing Birthing Centers Centers

Certified Hospital and Hospital- Pre- Community Yes NBCRNA Registered Community based Anesthesia based Pain Nurse based Birthing Clinics Clinics Anesthetist Surgical Centers Centers (CRNA)

Adult or Peds Walk in NCCPA Physicians' Ambulatory Operating Yes Ambulatory clinics/ assistant Family/ room, Clinics Urgent (PA) Internal specialty medicine Care

Supervision requirements: PA's practice under the license of the supervising physician and require a minimum of 20% chart co- signature based on delegation of services agreement. There is restricted opiate precsribing based on letter of agreement.

NP's practice under their own license and standardized procedures with the supervision of a physician. No cosignature required. Each physician can supervise up to 4 NP's.

*NP's and PA's must possess a masters' degree in their specialty AND national certification to bill under CMS.