Resident Handbook - UC Davis Health System

6. FPS resident if not the only senior covering inpatient services7. Residents on outpatient rotationsThe clinic manager or clinic director will make the final determination in cases that are unclear.SUPERVISION REQUIREMENTS FOR MEDI-CALCHW Graduate Medical Education Uniform Policy for California HospitalsThe requirements effective as of 2004 are more stringent than the Medicare billingrequirements. We will no longer be able to employ the 6-month Medicare exemption. Instead,we must have the teaching physician present for all billable patient care services performed byunlicensed residents. This includes all interns and all second year residents who have notreceived their licenses. More details about supervision guidelines are included below:FIRST YEAR RESIDENTS• All patients must be verbally presented in detail to the preceptor.• All patients seen by PGY1s must be physically seen and evaluated by the preceptor with caredocumented in the chart.• The preceptor must directly supervise all procedures.SECOND AND THIRD YEAR RESIDENTS• All patients seen by unlicensed PGY2s must be physically seen and evaluated by thepreceptor with care documented in the chart.• For licensed PGY2s and PGY3 s, all patient care must be reviewed with the preceptor duringor immediately after each visit.• E/M codes 99201, 99202, 99211 99212, 99203, and 99213 qualify for an exception and neednot be seen by the preceptor unless clinically warranted.• The preceptor must see all patients seen by residents on visits with E/M codes 99204, 99214,99205 and 99215.• The preceptor must directly supervise all proceduresPRECEPTOR RESPONSIBILITIES• May supervise no more than four residents (or other students) at any given time.• Must be on site and immediately available.• Must assume responsibility for care given by residents.• Must have no other responsibilities at the time of teaching (including supervision of otherpersonnel or clinical duties). An exception will be made when there is only one resident inclinic, during which time the preceptor may see one patient per hour.• Must review each patient’s care with each resident in a timely manner and appropriatelydocument the extent of his/her participation in the review and direction of care.• The preceptor must be present during all critical and key portions of all procedures.Page 152 of 153C:\Documents and Settings\dhutak\Desktop\rshb13.doc