Teaching physician rules: Basic concepts
CMS’s Teaching Physician documentation guidelines for when and how a teaching physician may bill if a resident is involved, requires the supervising physician to furnish a direct, personal physician service to the patient.
Physician services provided in a teaching setting are paid under the Medicare Physician fee schedule only if:
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A physician who is not a resident personally furnishes services.
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A teaching physician was physically present during the critical or key portions of the service that a resident performs subject to the exceptions as provided below in the following section: Documentation Instructions and Common Scenarios; or
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A teaching physician provides care under the conditions contained in section E&M Services Provided in Primary Care Centers which follows.
In all situations, the services of the resident are payable through either the direct GME payment or reasonable cost payments made by the fiscal intermediary