CMS Pub. 100-02, ch. 15, § 90

B3-2075

These services also include materials and services of technicians.

X-ray, radium, and radioactive isotope therapy furnished in a nonprovider facility require direct personal

supervision of a physician. The physician need not be in the same room, but must be in the area and

immediately available to provide assistance and direction throughout the time the procedure is being

performed. This level of physician involvement does not represent a physician’s service and cannot be

billed as a Part B service. The physician would have to furnish a reasonable and necessary professional

service as defined in §§30 of this chapter, in order for the physician’s activity to be covered.

However, effective for radiation therapy services furnished on or after April 1, 1989, radiologists’ weekly

treatment management services are covered.

A separate charge for the services of a physicist is not recognized unless such services are covered under the

“incident to” provision (§60.1 of this chapter) or the services are included as part of a technical component

service billed by a freestanding radiation therapy center. The incident to provision may also be extended to

include all necessary and appropriate services supplied by a radiation physicist assisting a radiologist when

the physicist is in the physician’s employ and working under his or her direct supervision.