CMS Pub. 100-04, ch. 12, § 100.1.6

In the case of maternity services furnished to women who are eligible for Medicare,

apply the physician presence requirement for both types of delivery as A/B MACs (B)

would for surgery. In order to bill for the procedure, the teaching physician must be

present for the delivery. These procedure codes are somewhat different from other

surgery codes in that there are separate codes for global obstetrical care (prepartum,

delivery, and postpartum) and for deliveries only. In situations in which the teaching

physician’s only involvement was at the time of delivery, the teaching physician should

bill the delivery only code. In order to bill for the global procedures, the teaching

physician must be present for the minimum indicated number of visits when such a

number is specified in the description of the code. This policy differs from the policy on

general surgical procedures under which the teaching physician is not required to be

present for a specified number of visits.

In the case of end stage renal related visits furnished under the monthly capitation

payment method (MCP), the physician presence policy as discussed in §100.1 applies.

Patient visits furnished by residents may be counted toward the MCP visits if the teaching

MCP physician is physically present during the visit. The teaching physician may utilize

the resident’s notes, however the teaching physician must document his or her physical

presence during the visit(s) furnished by the resident and that he or she reviewed the

resident’s notes. The teaching physician could document these criteria as part of an

extensive once a month MCP note.