Corporate Compliance

Physician supervision for on-campus provider-based departments

Medicare Insider, December 16, 2008

A colleague (another healthcare lawyer) contacted me last week to talk about CMS’s discussion in the 2009 Outpatient Prospective Payment System (OPPS) final rule of Medicare coverage for clinic visits furnished in a clinic located within a hospital. In a nutshell, my colleague pointed out that CMS now appears to be taking the position that Medicare coverage of therapeutic (i.e., non-diagnostic) services furnished by a non-physician in a clinic located within a hospital requires that a supervising physician be physically located in the clinic. She wondered, “Can they really be saying that?” Well, although not entirely clear, it appears that CMS may in fact be taking that position.

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