Biocompatible polymeric coating compositions having nanoscale surface roughness and methods of forming such coatings are described. A polymeric biocompatible coating may be produced using a powder coating method, where one or more thermosetting polymer resins and one or more biocompatible materials are mixed and extruded, ground into microscale particles, and mixed with nanoparticles to form a dry powder mixture that may be coated onto a substrate according to a powder coating method. Alternatively, the thermosetting polymeric resin can be first extruded and ground into microscale particles, and then mixed with the biocompatible materials in particular form of nanoscale to microscale in size, and then further mixed with nanoparticles to form a dry powder mixture for coating. Bioactive materials may also be selectively added into the polymeric coating in a similar way as the biocompatible materials, either before or after the extrusion, to form a bioactive polymeric coating.