| Highmark Medical Policy Bulletin |
| Section: | Miscellaneous |
| Number: | Z-27 |
| Topic: | Supervision Guidelines |
| Effective Date: | August 28, 2000 |
| Issued Date: | August 28, 2000 |
| Date Last Reviewed: | 08/1999 |
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:
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. |
Traditional (UCR/Fee Schedule) Guidelines
Comprehensive/Wraparound/PPO Guidelines
Managed Care (HMO/POS) Guidelines
PRN References |
| Term | Description |
|---|---|