Medicare’s Teaching Physician Billing Rules 2022— 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 required teaching physician notes are discussed. Key areas of concern are addressed, as well as efficient solutions to avoid common problems.
 

Target Audience

Baptist Health Graduate Medical Education faculty including family medicine practitioners, cardiologists, emergency medicine physicians, surgeons, hospitalists, obstetricians, gynecologists, nephrologists, hematologists/oncologists, infectious disease specialists, gastroenterologists, neurologists, ENT’s, ophthalmologists, urologists, pulmonologists, critical care physicians, medical students, residents, fellows and other interested healthcare professionals.   

Learning Objectives

  • Physicians will provide and document the appropriate level of participation/supervision for services performed by residents.
  • Residents will fully document the specifics of the medical service provided, including clinical scenario and management.  
Additional information
Bibliography: 
  • U.S. 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. https://www.cms.gov/files/document/covid-medicare-and-medicaid-ifc2.pdf 
  • U.S. Centers for Medicare & Medicaid Services. (2020). Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency. https://www.cms.gov/files/document/covid-final-ifc.pdf 
  • U.S. Centers for Medicare & Medicaid Services. (2020c, December 28). Medicare Program; CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/ Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID–19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID–19. Federal Register. Rules and Regulations, 85(248). https://www.govinfo.gov/content/pkg/FR-2020-12-28/pdf/2020-26815.pdf 
  • U.S. Centers for Medicare & Medicaid Services. (2022, February 28). COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing. https://www.cms.gov/files/document/03092020-covid-19-faqs-508.pdf 
  • U.S. Centers for Medicare & Medicaid Services. (2022). Medicare Claims Processing Manual. Chapter 12 - Physicians/Nonphysician Practitioners. https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c12.pdf 

Related Topics

Baptist Health Coding and Documentation e-Learning Series

This course provides practitioners with a comprehensive overview of documentation and coding changes necessary to make immediate changes to E&M coding levels, in addition to the CMS changes and mandates for telemedicine services due to the current health crisis.
Course Summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 General certificate of attendance
  • 1.00 Nurse Practitioners
Course opens: 
08/01/2022
Course expires: 
01/31/2023

Seth Canterbury, CPC, CPC-1
Healthcare Coding and Reimbursement Consultant 
Miami, FL 

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 for this 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.

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
Please login or register for a Baptist Health CME account to take this course.

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