BC Advantage - 2011 Issue 9

Meeting Medicare Physician Supervision Requirements

Outpatient services must meet minimum requirements for physician supervision when billed to Medicare, or claims will be denied as not reasonable or necessary. CMS defines three levels of physician supervision:1. General supervision: The service is furnished under the overall direction and control of the physician, but his or her physical presence is not required during the procedure.2. Direct supervision: The physician is physically present and is immediately available. As defined in the 2011 OPPS Final Rule, immediately available means "interruptible and able to furnish assistance and direction throughout the performance of the procedure but without reference to any...

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