Awareness : Did You Know? 2017

Did You Know? Weekly Educational Series 45

Defining Supervision Levels

The Code of Federal Regulations (42 CFR 410.32) defines three levels of supervision, as follows:

  1. General supervision: The service is furnished under the overall direction and control of the physician, but his or her physical presence is not required during the procedure.
  2. Direct supervision: The physician must be present on the same campus and immediately available to furnish assistance and direction throughout the performance of the procedure. As originally defined in the 2011 Outpatient Prospective Payment System Final Rule, “immediately available” means “interruptible and able to furnish assistance and direction throughout the performance of the procedure but without reference to any particular physical boundary.” The physician does not have to be in the room when the procedure is performed.
  3. Personal supervision: The physician is present in the room when the service is being performed. Per the Benefit Policy Manual (chapter 6, ยง20.4.4), “The supervisory responsibility is more than the capacity to respond to an emergency, and includes the ability to take over performance of a procedure and, as appropriate to the supervisory physician and the patient, to change a procedure or the course of care for a particular patient.”