CMS has revised or better defined several current policies for the supervision of outpatient services. The goal, per CMS, is “to ensure that hospital outpatient services are appropriately supervised by qualified practitioners while not impeding beneficiary access to these services, and in response to concerns raised by the hospital community.” In 2010, CMS will allow certain non-physician practitioners (NPP) (specifically physician assistants, nurse practitioners, clinical nurse specialists, certified nurse midwives, and licensed social workers) to provide direct super
Physician Supervision in the Hospital Outpatient Setting - Final 2010 OPPS Rule
According to CMS FAQ #8734:
An MUE (Medically Unlikely Edit) is a unit of service (UOS) edit for a Healthcare Common Procedure Coding System (HCPCS)/Current Procedural Terminology (CPT) code for services rendered by a single provider/supplier to a single beneficiary on the same date of service. The ideal MUE is the maximum unit of service that would be reported for a HCPCS/CPT code on the vast majority of appropriately reported claims. The MUE program provides a method to report medically reasonable and necessary UOS in excess of an MUE.
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