Medicare_Carriers_Manual / 15016 / 15016

Why This Topic Matters

Teaching physician claims depend on specific Medicare documentation and supervision requirements, and this guidance explains the major categories of services affected. It is useful for understanding how teaching settings, residents, and supervised services are addressed under Medicare policy.

Article Sections

1. Ed. Note

   A brief editorial reference to related manual material for teaching physicians, residents, and interns.

2. 15016. Supervising Physicians in Teaching Settings

   Core definitions used throughout the teaching physician policy and the baseline framework for services in teaching settings.

3. Payment for Teaching Physicians

   General rules describing when physician services in teaching settings are payable under the physician fee schedule and how resident services are handled.

4. General Documentation Instructions and Common Scenarios

   Documentation expectations for teaching-physician services, including common encounter patterns and student-related documentation considerations.

5. Exception for E/M Services Furnished in Certain Primary Care Centers

   A primary care exception pathway for selected evaluation and management services furnished in qualifying settings, including related operational conditions.

6. Procedures

   Supervision and billing rules for surgical, anesthesia, endoscopy, radiology, psychiatry, time-based services, and other complex or high-risk procedures.

7. Election of Costs for Services of Physicians in Teaching Hospital

   Rules for a teaching hospital’s election to receive reasonable cost payment instead of fee schedule payment for certain physician services.

8. Services of Assistants at Surgery Furnished in Teaching Hospitals

   Coverage and payment considerations for assistant-at-surgery services in teaching hospitals, including exceptions and specialty team situations.