Mid-Level Practitioners in Dermatology: A Need for Further Study and Oversight

inafter “mid-level providers”), has rapidly expanded. While originally envisioned to improve access to primary care in underserved areas under the supervision of a physician, mid-level providers have expanded their scope of practice and are now able to bill independently for the procedures they perform. In their article “Scope of Physician Procedures Independently Billed by Mid-Level Providers in the Office Setting,” 2 Coldiron and Ratnarathorn present data regarding common procedures billed independently by mid-level providers. Using the 2012 Medicare Physician/Supplier Procedure Summary Master File, provided annually by the Centers for Medicaid Services (CMS), this study identified the most common Current Procedural Terminology (CPT) codes billed independently by mid-level providers. Of the over 4 million procedures performed independently, nearly 55% of codes performed were in the area of dermatology. The most commonly performed dermatologic procedures are destruction of 2 to 14 premalignant lesions (CPT 17003) and biopsy of a single lesion (CPT 11100).