In Pennsylvania, third-party reimbursement is available to CRNPs.  Medicaid reimburses all CRNPs at 100% of physician payment.  Under the changes of the Balanced Budget Act of 1997, NPs are now eligible for direct Medicare reimbursement, regardless of the setting in which a service is performed.  Previously, reimbursement was limited to instances where NPs provided services "incident to" physician services and in rural health clinics.  Under the new law, payments to NPs will be 80% of the fee schedule or 85% of the fee schedule amount for the same service if provided by a physician.  Up-to-date information about reimbursement from federal programs is available from the American College of Nurse Practitioners at http://www.nurse.org/acnp.