# Nuclear stress test supervision



## Lisa Bledsoe (Apr 16, 2010)

I am looking for documentation/links that indicate whose presence is required at the time of a nuclear stress test.  Does this qualify as incident to for Medicare?  Can an RN be present when the test is done or does it have to be an MD, PA, or NP?  This is done in an office setting and the office owns the equipment.  Any help is greatly appreciated!!


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## Belinda Frisch (Apr 16, 2010)

*CMS Coverage Database*

All cardiovascular nuclear tests and stress tests must be referred by a physician or a qualified non-physician provider.

All stress tests must be performed under the direct supervision of a physician. 

The nuclear test components must be performed under the general supervision of a physician.


http://www.cms.gov/mcd/search.asp?from2=search.asp&

Use this link to find the full NCD/LCD for your locale. L26859 is the document ID. 

Direct supervision in the office setting means the physician must be present in the office suite and immediately available and able to provide assistance and direction throughout the time the service is performed. Direct supervision does not mean that the physician must be present in the same room with his or her aide.

General Supervision - means the procedure is furnished under the physician's overall direction and control, but the physician's presence is not required during the performance of the procedure. Under general supervision, the training of the nonphysician personnel who actually performs the diagnostic procedure and the maintenance of the necessary equipment and supplies are the continuing responsibility of the physician.


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## Lisa Bledsoe (Apr 16, 2010)

Thanks for the info Belinda.  I wasn't able to pull it up with that number, but in the interim I did find some other information stating the same as what you stated.  I appreciate the help!


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