Question:

Answer provided by Tatyana Kantor, CPB:

Regulations define levels of physician supervision for diagnostic tests as follows: 

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 performs 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 that 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

To determine the level of physician supervision, required for furnishing technical component of any test, providers may go the CMS web portal and check Medicare Physician Fee Schedule. Numerical level is assigned to each CPT or HCPCS code. 

To name a few:

• “0” Procedure is not a diagnostic test or procedure is a diagnostic test which is not subject to the physician supervision policy. 
• “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.