Medicare B New Issue 214 August 25, 2004
Related Change Request (CR) #: 3242 Medlearn Matters Number: MM3242
Related CR Release Date: June 18, 2004
Related CR Transmittal #: 17
Effective Date: October 4, 2004
Implementation Date: October 4, 2004
Instructions for Providing Supervisor's Information When a Service Incident to the Ordering Physician Is Supervised by Another Physician in the Group
Provider Types Affected
Physicians and non-physician practitioners
Provider Action Needed
Physicians and non-physician practitioners should note that this instruction clarifies that the supervisor's identification is required on a claim when a service performed incident to the service of one physician or non-physician practitioner is supervised by another member of the same group. It instructs how to report ordering physician and supervising physician information on the electronic claim form.
The preamble of the proposed rule for the Medicare Physician Fee Schedule on November 1, 2001 (66 Fed Reg. 55267) stated: "The billing number of the ordering physician (or other practitioner) should not be used if that person did not directly supervise the auxiliary personnel."
This rule was included by the Centers for Medicare & Medicaid Services (CMS) to give instructions for providing the supervisor's information on the CMS paper claim form (CMS-1500). Details regarding how to complete the paper claim form 1500 can be found in the Medicare Claims Processing Manual, Publication 100-04, Chapter 26 (Completing and Processing Form CMS-1500 Data Set), Section 10.4 (Items 14-33 - Provider of Service or Supplier Information). This CMS manual can be found at the following CMS web site:
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