Physicians at Teaching Hospitals (PATH) and the primary care exception rule (PCER) are important Medicare guidelines for teaching physicians that have been adopted by payers other than Medicare.

The guidelines for teaching physician services published by the Centers for Medicare & Medicaid Services (CMS) in the Medicare Claims Processing Manual (Chapter 12, Section 100.1.1) provide certain supervision requirements for physicians who bill for services provided in part by residents. Under the PATH guidelines, a teaching physician may bill for resident or fellow evaluation and management (E/M) services when one of the following conditions is met:

Each of these conditions requires the physical presence of the teaching physician for all of the key or critical components of the service. The PCER provides an exception to the PATH requirement that the teaching physician must be physically present during the critical or key portions of certain primary care services provided under his or...

You do not currently have access to this content.