Oncology & Hematology Coding Alert

Question: Can you explain the -physician supervision of diagnostic services- Medicare Fee Schedule section?


New Hampshire Subscriber
 

Answer: The Medicare Fee Schedule supervision indicators show the level of supervision required if a provider doesn't perform the service himself. The general rule is that the provider number you submit on the claim needs to match the person who performed the service, but there are exceptions that allow you to report either the performing or supervising provider.

- Level 01 is general supervision. The procedure is furnished under the physician's overall direction and control, but the service doesn't require the physician's presence during the procedure.

- Level 02 is direct supervision. The physician must be present in the office suite and immediately available to furnish assistance and direction.

- Level 03 is personal supervision. The physician must be in attendance in the room during the procedure.

- Level 09 is -concept does not apply.- Submit services listed with this designation under either the performing provider or the supervising provider number when you meet incident-to guidelines. 
 
Most radiation and medical oncology codes have a level of 09, but it's a good idea to check. Some codes have other levels, such as 77417 (Therapeutic radiology port film[s]), which requires general supervision (01).

Protect yourself: Check payer policy information, CPT guidelines, and fee schedule data to determine the level of supervision your payer requires for the codes you report.