What is physician presence

 Physician Presence


Radiologic supervision and interpretation (S&I) codes are used to describe the personal supervision of the performance of the radiologic portion of a procedure by one or more physicians and the interpretation of the findings. In order to bill for the supervision aspect of the procedure, the physician must be present during its performance. This kind of personal supervision of the performance of the procedure is a service to an individual beneficiary and differs from the type of general supervision of the radiologic procedures performed in a hospital for which A/B MACs (A) pay the costs as physician services to the hospital. The interpretation of the procedure may be performed later by another physician. In situations in which a cardiologist, for example, bills for the supervision (the “S”) of the S&I code, and a radiologist bills for the interpretation (the “I”) of the code, both physicians should use a “-52” modifier indicating a reduced service, e.g., only one of supervision and/or interpretation. Payment for the fragmented S&I code is no more than if a single physician furnished both aspects of the procedure.


Multiple Procedure Reduction

A/B MACs (B) make no multiple procedure reductions in the S&I or primary non-radiologic codes in these types of procedures, or in any procedure codes for which the descriptor and RVUs reflect a multiple service reduction. For additional procedure codes that do not reflect such a reduction, A/B MACs (B) apply the multiple procedure reductions.


Services of Portable X-Ray Suppliers


Services furnished by portable x-ray suppliers may have as many as four components. A/B MACs (B) must follow the following rules.


90.1 - Professional Component


Pay the PC of radiologic services furnished by portable x-ray suppliers on the same basis as other physician fee schedule services.

90.2 - Technical Component


Pay the TC of radiology services furnished by portable x-ray suppliers under the fee schedule on the same basis as TC services generally.