Many Current Procedural Terminology (CPT®) codes and modifiers include the term “qualified health care professional” in their definitions (eg, code 90460, immunization administration through 18 years of age via any route of administration, with counseling by physician or other qualified health care professional; first vaccine/toxoid component). Until recently, CPT, on page 468 of the American Medical Association Principles of CPT Coding, 6th Edition, defined qualified health care professional as
…those providers whose scope of practice as defined by regulation permits them to perform the service represented by the specific code…(with acknowledgment that)…licensure and credentialing vary on a state-bystate and institutional basis…(and that)…relevant state and institutional authorities should be consulted regarding the appropriate reporting of these services by qualified health care professionals.
The March 2011 CPT Assistant states
The addition of 'qualified health care professional' reflects the recognition that often registered nurse practitioners and physician assistants...