December 13, 2018

Revised RRA/RPA Supervision Levels Apply to Hospital Outpatient Settings

Registered radiologist assistants (RRAs) and radiology practitioner assistants (RPAs) can provide diagnostic test services under revised supervision levels defined for hospital outpatient setting in Transmittal 251, a regulatory directive from the Centers for Medicare and Medicaid Services (CMS) that goes into effect on Jan. 1, 2019.

A section entitled “Requirements for Diagnostic X-Ray, Diagnostic Laboratory, and Other Diagnostic Tests” describes the levels of physician supervision required for furnishing the technical component of diagnostic tests for a Medicare beneficiary who is not a hospital inpatient.

The section indicates supervision levels, assigned to each CPT or Level II HCPCS code in the Medicare Physician Fee Schedule (MPFS) Relative Value File, also apply to hospital outpatient diagnostic services and, therefore, allow RRAs and RPAs to provide these services under direct supervision as well.

The supervision rules do not apply to hospital inpatients, which means no Medicare regulation dictates supervision requirements in that practice setting.