Question We have a Family Practice Residency program and cannot find anything stating residents will be able to bill time based E&M in 2021.

SharonCollachi

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They will be the same as other providers - yes in the office, no in the ER. Is there a reason you think it will be different for them?
 

csperoni

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Wait - residents can bill for services under their own???
I always thought hospitals are reimbursed for the residency program and therefore cannot bill for resident services unless they are directly supervised by an attending and the documentation indicates such, in which case it's billed under the attending with -GC....
 

SharonCollachi

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Wait - residents can bill for services under their own???
I always thought hospitals are reimbursed for the residency program and therefore cannot bill for resident services unless they are directly supervised by an attending and the documentation indicates such, in which case it's billed under the attending with -GC....

The OP hasn't said if this is hospital or office.
 

AmberHart

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I was wondering if anyone has had any luck finding any information on this? I have been looking for a while now and have not been able to find anything either.
 

MLM1462

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It depends on POS. If services are being rendered are in the hospital then no, resident time does not count. But in the outpatient setting, if your practice qualifies for the Primary Care Exception then yes. As with all things Medicare, check your local MAC. Under the PCE our local MAC in NY (NGS) has gone on record as follows:
In a PCE setting, a teaching physician supervises up to four qualified residents and must remain available to the residents throughout the clinic session to see a patient personally at a resident’s request. Residents are permitted to see patients without the direct personal presence of the teaching physician and must review the plan of care for each patient with the teaching physician before the close of the clinic session. In the PCE setting only, total time for level-setting a visit includes the teaching physician’s time (in seeing the patient and/or reviewing the plan of care) and the resident’s time during his/her F2F encounter with the patient. Added 2/3/2021
 
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