In recent years, advanced practice nurses have achieved authority for the direct payment of their services under the four federal health programs--Medicare, Medicaid, Civilian Health and Medical Program of Uniformed Services, and the Federal Employee Health Benefit Plan. This article describes the importance of direct reimbursement and the barriers that have been overcome in achieving reimbursement. It also gives an overview of how advanced practice nurse services are covered and paid for in the federal programs. Increased authority has positioned nurses as visible members of the health care team. Direct payment for advanced practice nurses' services promotes public visibility for their role as direct providers of primary care and as managers of their patients' plan of care. Our nation is in an era of health care reform where additional primary care practitioners are needed. Recognition of advanced practice nurses allows them to be seen as a solution to our nation's pressing need for more primary care providers.