Question:

Has CMS made any 2018 changes to the Medicare policy for supervision of hospital outpatient therapeutic services?

Answer:

In the 2009 and 2010 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) final rules, the Centers for Medicare & Medicaid Services (CMS) clarified that direct physician supervision is generally required for hospital outpatient therapeutic services that are furnished in hospitals, critical access hospitals (CAHs), and in provider-based departments of hospitals. For several years, there has been a moratorium on the enforcement of the direct supervision requirement for CAHs and small rural hospitals, with the latest moratorium on enforcement expiring on December 31, 2016.

In the latest final rule, CMS reinstated the non-enforcement of direct supervision requirements for outpatient therapeutic services for CAHs and small rural hospitals having 100 or fewer beds for 2018 and 2019.

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