The October 2011 AAP Pediatric Coding Newsletter™ addressed teaching physician guidelines under the primary care exception rule (PCER) of the Medicare teaching physician rules. Since that article ("A Refresher Course: Teaching Physician Guidelines for Supervising Residents in the Office or Clinic") was published, the Centers for Medicare & Medicaid Services (CMS) has provided clarification on how the PCER applies to supervision of a resident with less than 6 months in an approved graduate medical education (GME) residency program.

Please make note of the following changes as published in CMS Transmittal 2303, Change Request 7378 (www.cms.gov/transmittals/downloads/R2303CP.pdf); the Medicare Claims Processing Manual, sections 100.1 and 100.1.1 (C) (www.cms.gov/manuals/downloads/clm104c12.pdf); and the CMS Physicians Regulatory Issues Team Web site (www.cms.gov/prit/pritia/list.asp).

“Teaching physicians submitting claims under this exception may not supervise more than four residents at any given time and must direct the care from such proximity as...

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