Medicare’s Teaching Physician Billing Rules 2021— with COVID-19 PHE Allowances

This presentation outlines the documentation and billing requirements of teaching physicians for services rendered to patients by medical residents. Required levels of teaching physician supervision and sample verbiage for physician notes are discussed. Key areas of concern are addressed, as well as efficient solutions to avoid common problems.

Target Audience

West Kendall Baptist Hospital GME faculty, including: family medicine practitioners, cardiologists, emergency medicine physicians, surgeons, hospitalists, obstetricians/gynecologists, nephrologists, hematologists/oncologists, infectious disease specialists, gastroenterologists, neurologists, ENTs, ophthalmologists, urologists, pulmonologists, critical care physicians, advanced practice registered nurses, medical students, residents, fellows and other interested healthcare professionals. 

Learning Objectives

  • Physicians will execute providing and documenting the appropriate level of participation/supervision for services performed by residents.
  • Residents will implement documenting the specifics of the services, including clinical scenario and management.  
Additional information
Bibliography: 
  • Centers for Medicare & Medicaid Services. (2020). 2021 Medicare Physician Fee Schedule Final Rule Federal Register, 85(248), 84472-85377. https://www.govinfo.gov/content/pkg/FR-2020-12-28/pdf/2020-26815.pdf
  • Centers for Medicare & Medicaid Services. (2020). Medicare and Medicaid Programs, Basic Health Program, and Exchanges; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program. (CMS-5531-IFC). Baltimore, MD Retrieved from https://www.cms.gov/files/document/covid-medicare-and-medicaid-ifc2.pdf
  • Centers for Medicare & Medicaid Services. (2020). Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency. (CMS-1744-IFC). Baltimore, MD: Centers for Medicare & Medicaid Services Retrieved from https://www.cms.gov/files/document/covid-final-ifc.pdf
  • Centers for Medicare & Medicaid Services. (2021). Chapter 12 - Physicians/Nonphysician Practitioners. In Medicare Claims Processing Manual. Centers for Medicare & Medicaid Services. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf
  • Centers for Medicare & Medicaid Services. (2021). COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing. Baltimore, MD Retrieved from https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
Course opens: 
08/01/2021
Course expires: 
07/31/2022

Seth Canterbury, CPC
Healthcare Coding and Reimbursement Consultant
Canterbury and Associates

Seth Canterbury, CPC, faculty for this educational activity, has no relevant financial relationships with ineligible companies* to disclose, and has indicated that the presentation or discussion will not include off-label or unapproved product usage.

Agueda Hernandez, M.D., conference director of this educational activity, has no relevant financial relationships with ineligible companies* to disclose.

Non-faculty contributors and others involved in the planning, development and editing/review of the content have no relevant financial relationships to disclose with ineligible companies.*

*Ineligible companies – Companies whose primary business is producing, marketing, selling, re-selling or distributing healthcare products used by or on patients.

Disclosure Policy and Disclaimer

Baptist Health South Florida is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Baptist Health has been re-surveyed by the ACCME and awarded Commendation for 6 years as a provider of CME for physicians.
              
Baptist Health South Florida designates this enduring material for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
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