Levels of Supervision Required by Medicare

by  Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
February 26th, 2015

Be sure you know and understand the levels of supervision required so as not to result in non-compliance audits, possible fines and take-backs. Supervision requirements may also affect your documentation requirements; be sure to document the presence during the procedure or performance if it requires personal supervision.

Find-A-Code has levels of supervision built into each code. To locate the level of supervision requirement in Find-A-Code select the desired code and open: 

ADDITIONAL INFORMATION tab to view PHYSICIANS SUPERVISIONS

For example, CPT code:

96101- Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic

Physician Supervisions: 9 - Concept does not apply.  

Definitions: Levels of Supervision

General Supervision - means the procedure is furnished under the physician's overall direction and control, but the physician's presence is not required during the performance of the procedure. Under general supervision, the training of the nonphysician personnel who actually perform the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician.

Direct Supervision - in the office setting means the physician must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure. It does not mean the physician must be present in the room when the procedure is performed.

Personal Supervision - means a physician must be in attendance in the room during the performance of the procedure.

 

Supervision IndicatorExplanation
1 Procedure must be performed under the general supervision of a physician.
2 Procedure must be performed under the direct supervision of a physician.
3 Procedure must be performed under the personal supervision of a physician.
4 Physician supervision policy does not apply when procedure is furnished by a qualified, independent psychologist or a clinical psychologist or furnished under the general supervision of a clinical psychologist; otherwise must be performed under the general supervision of a physician.
5 Physician supervision policy does not apply when procedure is furnished by a qualified audiologist; otherwise must be performed under the general supervision of a physician.
6 Procedure must be performed by a physician or by a physical therapist (PT) who is certified by the American Board of Physical Therapy Specialties (ABPTS) as a qualified electrophysiologic clinical specialist and is permitted to provide the procedure under State law.
6a Supervision standards for level 66 apply; in addition, the PT with ABPTS certification may supervise another PT but only the PT with ABPTS certification may bill.
7a Supervision standards for level 77 apply; in addition, the PT with ABPTS certification may supervise another PT but only the PT with ABPTS certification may bill.
9 Concept does not apply.
21 Procedure must be performed by a technician with certification under general supervision of a physician; otherwise must be performed under direct supervision of a physician.
22 Procedure may be performed by a technician with on-line real-time contact with physician.
66 Procedure must be performed by a physician or by a PT with ABPTS certification and certification in this specific procedure.
77 Procedure must be performed by a PT with ABPTS certification or by a PT without certification under direct supervision of a physician, or by a technician with certification under general supervision of a physician.

 

The supervision level definitions may also be found in the Internet Only Manual System, publication 100-02, Chapter 15, Section 80. For more information visit Findacode.com INFO/Medicare Information

 

References:

Levels of Supervision Required by Medicare. (2015, February 26). Find-A-Code Articles. Retrieved from https://www.findacode.com/articles/levels-of-supervision-changes-2696.html

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