Direct Supervision of Hospital Outpatient Services

Direct supervision. For the past four years, CMS has modified its policies related to the "direct supervision" of outpatient therapeutic services, threatening to magnify physician shortage problems. For 2013, at the AHA's urging, CMS adopted several positive changes to the regulations. Specifically, the agency:

• Allowed non-physician practitioners authorized to furnish direct supervision to also provide general or personal supervision for certain services;
• Modified the definition of direct supervision to remove all references to the physical boundaries within which the supervising practitioner must be located as long as he or she is "immediately available to furnish assistance and direction throughout the performance of the procedure;"
• Established a process for independent review of alternate supervision levels using the Advisory Panel on Hospital Outpatient Payments; and
• Delayed enforcement of the direct supervision policy through calendar year (CY) 2013 for CAHs and small and rural hospitals with fewer than 100 beds.

AHA Factsheet: Supervision of Hospital Outpatient Therapeutic Services

CMS Direct Supervision Exceptions File - Hospital Outpatient Therapeutic Services

AHA November 30th Regulatory Action Alert: Hospital Need to Weigh in on Supervision Policy for Outpatient Therapeutic Services