CMS recognizes three primary levels of physician supervision. In the context of outpatient diagnostic services, these are defined as:
1. General supervision: The procedure is furnished under the physician’s overall direction and control. The physician must order the diagnostic test and is responsible for training staff performing the tests, as well as maintaining the testing equipment. He or she does not need to be present in the room during the procedure.
2. Direct supervision: In the physician office, the supervising physician must be present in the office suite and immediately available to furnish assistance and direction throughout the performance of the procedure.
3. Personal supervision: A physician must be in attendance in the room during the performance of the procedure. Regardless of location, if a physician personally provides the entire service, supervision requirements are not a concern.