Medical students providing care
Kaiser Permanente expects providers to comply with all applicable CMS billing standards. This includes but is not limited to the following:
A student is an individual who participates in an accredited educational program (e.g., a medical school) that is not an approved Graduate Medical Education (GME) Program. Medicare does not pay for any service furnished by a student. Interns or residents are not students and therefore are exempt.
Any contribution and participation of a student to the performance of a billable service (other than the review of systems and/or past family/social history which are not separately billable, but are taken as part of an Evaluation and Management [E&M] service) must be performed in the physical presence of a teaching physician or physical presence of a resident in a service meeting the requirements for teaching physician billing.
Students may document services in the medical record. However, the documentation of an E&M service by a student that may be referred to by the teaching physician is limited to documentation related to the review of systems and/or past family/social history.
The teaching physician may not refer to a student's documentation of physical exam findings or medical decision-making in his or her personal note. If the medical student documents E&M services, the teaching physician must verify and re-document the history of present illness as well as perform and re-document the physical exam and medical decision making activities of the service.
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