| |
| Section: |
Miscellaneous |
| Number: |
Z-27 |
| Topic: |
Supervision Guidelines |
| Effective Date: |
August 28, 2000 |
| Issued Date: |
August 28, 2000 |
| Date Last Reviewed: |
08/1999 |
General Policy Guidelines
Covered services provided for subscribers must be personally performed by an eligible professional provider, or under the provider's direct personal supervision. The following providers are eligible when, duly licensed and acting within the authority of their licenses:
- Audiologists
- Certain certified registered nurses
- Doctors of Chiropractic
- Clinical laboratories
- Dentists
- Doctors of medicine
- Doctors of osteopathy
- Nurse midwives
- Optometrists
- Physical therapists
- Podiatrists
- Psychologists
- Speech pathologists
- Teachers of the hearing impaired
Covered services performed under the personal supervision of an eligible provider by a licensed health care practitioner (e.g., physician's assistant, licensed clinical social worker, and registered physical therapy assistant) in his employment may be eligible. (See Medical Policy Bulletin Z-33 for information on employment relationship criteria. See Medical Policy Bulletins S-86 and Z-10 for information on physician's assistants. See Medical Policy Bulletin Y-1 for information on physical therapy.)"Personal supervision" means that the provider must be in the immediate vicinity so that he can personally assist in the procedure, or to assume primary care of the patient, if necessary. Such services are eligible only if the criteria of appropriate licensure, employment, and supervision are met. (See Medical Policy Bulletin A-3 for additional information on supervision of anesthesia services.) Availability of the provider by telephone does not constitute direct personal supervision. |
 |
Procedure Codes
Traditional (UCR/Fee Schedule) Guidelines
FEP Guidelines
Comprehensive/Wraparound/PPO Guidelines
Managed Care (HMO/POS) Guidelines
Publications
PRN References
06/1994, New providers now eligible to participate with Blue Shield
10/1994, Supervision guidelines
08/1995, Massage therapists' services
08/1999, Chiropractic assistants' services not covered
08/1999, Certified Registered Nurses
10/1999, Physician Assistants
04/2000, Eligibility requirements for supportive personnel
|
References
View Previous Versions
No Previous Versions
Table Attachment
Text Attachment
Procedure Code Attachment
Glossary
Medical policies do not constitute medical advice, nor are they intended to govern the practice of medicine. They are intended to reflect Highmark's reimbursement and coverage guidelines. Coverage for services may vary for individual members, based on the terms of the benefit contract.
Highmark retains the right to review and update its medical policy guidelines at its sole discretion. These guidelines are the proprietary information of Highmark. Any sale, copying or dissemination of the medical policies is prohibited; however, limited copying of medical policies is permitted for individual use.
|
