Incident-to services require which type of supervision?

• A. General supervision
• B. Personal supervision
• C. Physician-Direct supervision
• D. No supervision

Answer: (C)

Incident-to services are the non-physician procedures performed under a physician’s supervision but billed as if the physician performed them. For Medicare reimbursement, the supervising physician must be physically present in the office suite and immediately available to provide assistance and direction during the service. This requirement is known as physician-direct supervision. It ensures the clinician’s oversight is close enough that the physician can step in right away if needed, while the actual hands-on work is carried out by qualified non-physician staff.

Other supervision levels don’t meet this standard: general supervision allows the physician to be available but not necessarily in the same location; personal supervision requires the physician to be in the room with the patient; neither satisfies the need for the physician to be present in the office suite and immediately available.