Participation and Documentation Requirements for Teaching Physician Billing and Coding

Miami, FL US
June 22, 2017

Course Description: Services Furnished by an Intern or Resident Within the Scope of an Approved Training Program:

Medical and surgical services furnished by an intern or resident within the scope of his or her training program are covered as provider services and Medicare pays for them through Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) payments. These services may not be billed or paid under the Medicare PFS. When interns or residents are in an approved program and training in a nonprovider setting, the services furnished are payable in one of the following ways:

a. Through DGME and IME payments to the hospital(s), if, among other things, he or she: Provides patient care activities and the hospital(s) incurs salary and fringe benefits of the resident or intern during the time spent in the nonprovider setting; or

b. For DGME purposes, spends time in certain nonpatient care activities in certain nonprovider settings and the hospital(s) incurs salary and fringe benefits of the resident or intern during the time he or she spent in the nonprovider setting; or

c. Through the Medicare PFS if, in part, the regulations concerning the hospital’s receipt of DGME and IME payments are not met for the time spent in a nonprovider setting, and the time spent in the nonprovider setting is not counted by the hospital for DGME and IME payment purpose.

http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Teaching-Physicians-Fact-Sheet-ICN006437.pdf

Target Audience

West Kendall Baptist Hospital GME faculty including:  Family medicine practitioners, cardiologists, emergency medicine physicians, surgeons, hospitalists, Ob/Gyn’s, nephrologists, hematologists/oncologists, infectious disease specialists, gastroenterologists, neurologists, ENT’s, ophthalmologists, urologists, pulmonologists, critical care physicians, nurses, medical students, residents, fellows and other interested healthcare professionals.  

Learning Objectives

  • Recognize situations in which the teaching physician billing rules apply.
  • Summarize the specific documentation residents must record to demonstrate the required amount of teaching physician   participation/performance was rendered.
  • Implement specific participation/performance requirements that exist for each type of resident service.
  • Identify when pertinent billing requirements have been met by the teaching physician. 

Registration is only open to WKBH GME Faculty

Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™
  • 1.00 Nurse Practitioners
  • 1.00 General certificate of attendance
Course opens: 
05/16/2017
Course expires: 
07/19/2017
Event starts: 
06/22/2017 - 5:00pm
Event ends: 
06/22/2017 - 6:00pm
Rating: 
0
West Kendall Baptist Hospital
9555 SW 162 Avenue
Family Medicine Center – Medical Arts Building, Suite 200
Miami, FL 33196
United States

Seth Canterbury
Healthcare Coding and Reimbursement Consultant


Mr. Seth Canterbury has indicated that neither he nor his spouse/partner have relevant financial relationships with commercial interest companies, and he will not include off-label or unapproved product usage in his presentation(s) or discussion(s).

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

Available Credit

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

Accreditation Period

Course opens: 
05/16/2017
Course expires: 
07/19/2017
Please login or register to take this course.

Registration is open only for WKBH GME Faculty