The Centers for Medicare & Medicaid Services on Sept. 24 proposed reducing the supervision level for 15 outpatient services from direct to general supervision, including certain vaccine administrations, blood collection, bladder catheter insertion and intravenous hydration services. The Hospital Outpatient Payment Panel recommended the change last month.
If finalized, the CMS recommendation would allow the services to be performed under the overall direction of a physician or non-physician practitioner without requiring their presence. The panel also recommended reducing the supervision level for 13 other outpatient therapeutic services, including hospital observation, IV drug infusions, drug injections, and bladder irrigation services.
CMS did not accept the panel’s recommendation for those services, saying they involve physician assessment or have significant potential for patient complications or reactions that would require the immediate availability of a supervising physician or nonphysician practitioner. CMS will accept comments on its preliminary decision via e-mail through Oct. 24 at HOPSupervisionComments@cms.hhs.gov.