Private Duty Nursing

To determine if this service is a benefit of your patient's plan, please call a Provider Services Representative.

Private duty nursing services are payable when all of the following guidelines are met:

• Services are rendered by a duly licensed registered nurse (R.N.) or licensed practical nurse (L.P.N.).
• Services are directed by the attending physician.
• Services are consistent with the diagnosis and treatment of an illness or injury for which benefits are or may be provided under the medical plan certificate.

Exclusions

• If the skills of an R.N. or L.P.N. are not essential, or would normally be provided to an inpatient by the hospital or skilled nursing facility, no payment will be made for such services.
• Services rendered by a member of the beneficiary's family are not payable.

Revision History