This statement is describing the legality surrounding 'incident-to services', which can be provided by a medical assistant, RN, LPN, etc., under the direct supervision of a physician or otherwise credentialled non-physician practitioner: i.e. someone who is credentialled to bill independently. 'Direct supervision' means that this provider must be in the same suite at the time, but doesn't necessarily have to be in the exam room. To bill without physician supervision is fraudulent except for one example within a physician practice that I am aware of. Our Medicare contractor, NHIC allows us to bill flu shots at a flu clinic without direct physician supervision. Lab drawing sites are also able to bill without direct physician supervision, but that's not my area of expertise. Maybe someone else can comment.
Aside from the obvious billing concerns, I would question the safety of providing any kind of medical service without the presence of a licensed practitioner.
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