CMS Pub. 100-02, ch. 13, § 110

The term “physician” includes a doctor of medicine, osteopathy, dental surgery, dental

medicine, podiatry, optometry, or chiropractic who is licensed and practicing within the

licensee’s scope of practice, and meets other requirements as specified.

Physician services are professional services furnished by a physician to an RHC or

FQHC patient and include diagnosis, therapy, surgery, and consultation. The physician

must either examine the patient in person or be able to visualize directly some aspect of

the patient’s condition without the interposition of a third person’s judgment. Direct

visualization includes review of the patient’s X-rays, EKGs, tissue samples, etc.

Except for services that meet the criteria for authorized care management or virtual

communications services, telephone or electronic communication between a physician

and a patient, or between a physician and someone on behalf of a patient, are considered

physicians’ services and are included in an otherwise billable visit. They do not

constitute a separately billable visit.

Qualified services furnished at an RHC or FQHC or other authorized site by an RHC or

FQHC physician are payable only to the RHC or FQHC. RHC and FQHC physicians are

paid according to their employment agreement or contract (where applicable).