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September 2, 2025

Coding Guide – Teaching Physician Rules

The teaching physician guidelines are Medicare rules that allow for payment for services that are performed jointly between a resident and a licensed attending physician (the teaching physician). This downloadable coding guide from CodingIntel provides an explanation of teaching physician rules for E/M services and specialty specific services.

Teaching Physician Rules | Quick Reference Guide

This quick reference guide breaks down who must document what for which services as outlined in Medicare’s teaching physician rules.

Teaching Physician – Primary Care Exception

CMS updated the teaching physician rules in 2019, and this article reflects the change. On April 26, 2019 CMS released Transmittal 4283. The transmittal primarily addresses E/M services, but also amends the section of the manual related to the primary care exception.  The changes to the primary care section were mostly wording updates. Those rules […]

Teaching Physician Rules – Evaluation and Management Services

CMS policy update: E/M services performed under the teaching physician rules Download this teaching physician rules quick reference sheet for a summary of the rules. The CMS rules got a major update with the April 26, 2019 Transmittal 4823. A transmittal is a communication from CMS to the Medicare Administrative Contractors. It is followed by […]

Teaching Physician Rules | Bedside Procedures

Question: Can an attending bill for a bedside procedure that a resident did without the attending being present? If so, is this billed at 85% like a PA or NP? If a PA or NP is overseeing a bedside procedure that a resident is preforming how is this billed (no attending is present at the […]

Teaching Physician Rules and Surgical Procedures

The teaching physician rules describe a payment method by which Medicare pays an attending physician or teaching physician for services performed jointly with an intern, resident, or fellow, in an approved graduate medical education program (GME). The teaching physician’s presence and participation is required. The rules regarding participation and documentation vary by the type of […]

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Our mission is to provide up-to-date, simplified, citation driven resources that empower our members to gain confidence and authority in their coding role.

In 1988, CodingIntel.com founder Betsy Nicoletti started a Medical Services Organization for a rural hospital, supporting physician practice. She has been a self-employed consultant since 1998. She estimates that in the last 20 years her audience members number over 28,400 at in person events and webinars. She has had 2,500 meetings with clinical providers and reviewed over 43,000 medical notes. She knows what questions need answers and developed this resource to answer those questions.

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