Code Level Supervision

The supervision level required for diagnostic services is assigned by CMS. A list of diagnostic procedures and the supervision level required for each service is available in the CMS Medicare Physician Fee Schedule Database.

Once on the site, follow these steps to view the physician supervision level:

Accept attestation Agreement.
You will be on the Physician Fee Schedule Search page. The screen defaults to the current year.
Under Type of Information, select Payment Policy Indicators.
Under the Select HCPCS Criteria screen, select Single HCPCS Codes, List of HCPCS Codes, or Range of HCPCS Codes.
Enter the procedure code(s).
Select All Modifiers from the drop-down.
Click Submit. The payment policy information should appear.
Look in column 12 labeled PHYS SUPV.

The supervision indicator describes the levels of physician supervision required for furnishing the technical component of diagnostic tests for a Medicare beneficiary who is not a hospital inpatient.

42 Code of Federal Regulation (CFR), Section 410.32(b) requires diagnostic tests covered under Section 1861(s)(3) of the Act and payable under the physician fee schedule, with certain exceptions listed in the regulation, have to be performed under the supervision of an individual meeting the definition of a physician (Section 1861[r] of the Act) to be considered reasonable and necessary and, therefore, covered under Medicare.

Supervision Indicator	Explanation
1	Procedure must be performed under the general supervision of a physician.
2	Procedure must be performed under the direct supervision of a physician.
3	Procedure must be performed under the personal supervision of a physician.
4	Physician supervision policy does not apply when procedure is furnished by a qualified, independent psychologist or a clinical psychologist or furnished under the general supervision of a clinical psychologist; otherwise must be performed under the general supervision of a physician.
5	Physician supervision policy does not apply when procedure is furnished by a qualified audiologist; otherwise must be performed under the general supervision of a physician.
6	Procedure must be performed by a physician or by a PT who is certified by the ABPTS as a qualified electro-physiologic clinical specialist and is permitted to provide the procedure under state law.
6a	Supervision standards for level 66 apply; in addition, the PT with ABPTS certification may supervise another PT but only the PT with ABPTS certification may bill.
7a	Supervision standards for level 77 apply; in addition, the PT with ABPTS certification may supervise another PT but only the PT with ABPTS certification may bill.
9	Concept does not apply.
21	Procedure must be performed by a technician with certification under general supervision of a physician; otherwise must be performed under direct supervision of a physician.
22	Procedure may be performed by a technician with online real-time contact with physician.
66	Procedure must be performed by a physician or by a PT with ABPTS certification and certification in this specific procedure.
77	Procedure must be performed by a PT with ABPTS certification or by a PT without certification under direct supervision of a physician, or by a technician with certification under general supervision of a physician.

Code Level Supervision

Related Content