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.

The level of participation and required documentation differ based on the type of service that is performed. But whatever the medical service, there must be documentation of the attending’s participation in the care of the patient. This is an area of high compliance risk and academic practices need to educate and re-educate with every new group of residents and recently hired attending physician.

The Medicare manual has specific definitions related to teaching physician guidelines. There is a CMS citation at the end of this guide for readers who want to learn more.

Table of Contents

• Quick reference sheet
• 2018 rule change for student services
• E/M services rule change reducing burden
• Critical care
• Primary care exception
• Psychiatry services
• Surgical services
• Required documentation reference

For additional resources, see teaching physician articles and tips which include a quick reference cheat sheet, and

Review the complete Medicare Guidelines

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