Hi Ingrid,
This article is recent in Nursing Economics and may be of some help. All research I have done on RN billing says that in order for a nurse to bill higher, a billable provider (NP or Physician) must be involved in the visit. Do you have a provider evaluating the patient to determine need for the service? if so, you would likely use their ability to bill for the visit, even if you are having an RN perform the service. I believe some organizations get around this by having a provider "involved," as in, saying hello to the patient and setting the stage for the RN service, and then the RN performs. This frees up the provider to do admin work while the RN takes care of the patient and the reimbursement is higher.
That being said, there is a lot going on on the lobbying side to get legislation passed to allow RN's to bill at higher rates of reimbursement. Rebecca Love is a HUGE voice in this, if you follow her on LinkedIn. Our Advocacy Committee is heavily into this work as well. I wonder if someone from that group might of help. Not sure who the board liaison is for that group, but I could find out!
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Torie Bonnet MSN RN NE-BC NPD-BC
Associate Director of Nursing
Piedmont Health
Raleigh NC
bonnett@piedmonthealth.org------------------------------
Original Message:
Sent: 11-14-2025 10:22
From: Kristin Hawkinson
Subject: Creating an Ambulatory RN position
Wanted to jump in on this conversation - I just started an evidence-based nurse-run manual earwax removal clinic within my department. This procedure is NOT of "minimal complexity" because we use otomicroscopy, hand tools, and microsuction. Before our nurses can do it they must go through an extensive competency involving observations and proctored exams. The 99211 billing code just doesn't cut it because the amount we bring in for reimbursement is so minuscule compared to what an APP brings in for the exact same thing.
Any ideas for alternative codes or where I might look for such things? As you mentioned, ambulatory nurses can do so many skilled tasks to bring in revenue and increase access, but the billing code doesn't do us justice when we're performing complex tasks.
Ingrid Hawkinson RN, AMB-BC, MSN
UCSF Otolaryngology
2380 Sutter Street
San Francisco, CA 94117
415-353-2148
Original Message:
Sent: 11/13/2025 8:34:00 AM
From: Torie Bonnet
Subject: RE: Creating an Ambulatory RN position
Hi!
Lots of amazing resources (and people) within this organization to help with this!! Here are a few:
https://myfcbilling.com/cpt-code-99211/
@Deborah Cantlin is a wealth of knowledge on nurse led visits.
In the NSI SIG there are a couple of booming threads on nurse led clinics and nurse led visits. I recommend checking out that SIG and reading through what some of the leaders are doing there.
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Torie Bonnet MSN RN NE-BC NPD-BC
Associate Director of Nursing
Piedmont Health
Raleigh NC
bonnett@piedmonthealth.org
Original Message:
Sent: 11-12-2025 14:22
From: Monique McBride
Subject: Creating an Ambulatory RN position
Hi there!
I am in the midst of trying to create an RN position for ambulatory care (primary care with sub specialties) and could really use some guidance. I am under the impression that there is quite a bit that an RN can bill for to bring in revenue. I have taken the CPT codes from the AAACN guide as well as the listed ways RNs can help. Does anyone have any guidance for me on anything related to implementing a new role? I am not sure what all the RN can do etc. I have created a justification and a tentative "RN schedule" with possible revenue reimbursement" but wondering if I am even on the right track. The nurse I was working with who started all of this left the company so I feel like I am stuck. Open to any and all resources, guidance and helpful tips!! I have attached the proposal I came up with- but again just kind of playing around with it.
Thank you so much!
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Monique McBride
BSN, RN, Supervisor
Sutter Health
Rocklin CA
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