Teaching Physician Rules and Documentation – Where Are We Post Pandemic (PHE)?

Residents in training are licensed physicians.  But in their role as trainees they are not providers who can bill for their services.  Their work is overseen by physicians who are in charge of their training, called teaching physicians.  These training programs, generally, get some funding from the Medicare system which is why we look to CMS/Medicare for rules regarding coding and billing and the documentation of services these residents perform.  Residents are not allowed to function autonomously, as they are in training.  What types of patient care they can perform is determined by where they are in their training and their individual program guidelines.  The level of supervision CMS/Medicare requires them to have is found within Medicare’s Policies and Procedures and refers to the Key portions of the service.  CMS/Medicare gives guidance on who can document what, when residents are performing a service with a patient.  This is true for procedures, surgeries and evaluation and management services.  Many, many rules were in CMS/Medicare’s manuals when the pandemic hit, and the Public Health Emergency (PHE) began. Most were exempted or paused until the end of the PHE as efforts were made to allow anyone with medical training to work to their fullest, as independently as possible.  This was to take care of the growing numbers of COVID-19 patients.    

When the PHE ended, like trying to put a Gennie back in the bottle, it seems to be difficult for CMS/Medicare to go back to the old rules.  Most of the exempted rules are still in place months after they were set to expire.  Physicians and practices that work with residents, need to understand which rules are still in place, which have been changed and when those changes may expire.

Webinar Objectives

This webinar will outline what CMS/Medicare rules are for teaching physicians.  Our expert speaker will then discuss which of those rules are in place, which are still exempted, and which have been altered for the long term.  Documentation of Evaluation and Management notes, Critical Care notes, procedure and surgical notes and other services are all part of the discussion.

Webinar Agenda

• Teaching physician rules from Medicare’s IOM will be explained in detail
• Next, the exemptions for these put in place for these rules during the PHE will be reviewed
• Lastly, where the teaching physician rules are for 2024 will be discussed

Webinar Highlights

• What is the proper wording for a pre-PHE teaching physician note?
• What is the proper wording for a current teaching physician note under the current post-PHE guidelines?
• What level of supervision is required for residents?
• What documentation of that supervision is required?
• What can residents, interns or medical students document?
• What documentation must the teaching physician make?
• Where does the teaching physician need to be located during a patient service performed by a resident?
• Can residents perform telehealth visits?

Who Should Attend

Billers, Auditors, Practice Managers, Office managers, Teaching Physicians