Mastering Provider-Based Hospital Outpatient Billing & Supervision in 2025

Overview

Billing for hospital outpatient services under a provider-based model is highly regulated and often challenging to navigate. In this structure, the hospital serves as the principal provider and assumes operational and financial responsibility for affiliated outpatient departments. These departments—whether located on or off the hospital campus—are considered extensions of the hospital itself, which subjects them to increased regulatory oversight.

Success in this billing environment requires deep knowledge of compliance standards, careful designation of provider-based status, and proper reimbursement practices. Medicare has set strict guidelines for these arrangements, especially around physician supervision. The rules differ based on service type—diagnostic vs. therapeutic—as well as whether the care is delivered on-campus or at an off-campus location.

This in-depth webinar will walk attendees through the 2025 regulatory expectations for physician supervision in provider-based billing. It will cover the distinctions between general, direct, and personal supervision and detail how those requirements vary by service type and location.

Learning Goals

Understanding and applying the proper physician oversight levels is key to maintaining compliance and avoiding costly errors in provider-based billing structures. This session will help healthcare professionals stay up to date with the latest 2025 Medicare supervision rules and ensure their billing practices align with federal expectations.

Learning Objectives

• Review updated 2025 Medicare regulations for achieving and maintaining provider-based status

• Identify and differentiate the types of physician supervision required under provider-based billing

• Understand the specific rules for diagnostic services and how they apply to supervision levels

• Learn about supervision expectations for therapeutic services delivered in a provider-based model

• Distinguish the differences in supervision between on-campus and off-campus hospital departments

• Examine real-world scenarios to illustrate how supervision requirements are applied in practice

Webinar Topics

• Compliance Requirements: Key regulations for establishing and maintaining provider-based status in 2025

• Supervision Types: Clear definitions and responsibilities tied to general, direct, and personal physician supervision

• Diagnostic Services: Supervision expectations for diagnostic procedures performed in provider-based settings

• Therapeutic Services: Oversight and documentation requirements for therapeutic interventions

• Campus Designation: Comparing the supervision standards for hospital departments located on-campus vs. off-campus

• Case Scenarios: Practical examples illustrating how to apply supervision rules in different settings

Who Should Attend

This session is ideal for professionals involved in hospital billing, compliance, and revenue cycle operations, including:

• Medical Coders & Billers

• Healthcare Auditors

• Clinical Documentation and HIM Professionals

• Revenue Cycle & Revenue Integrity Teams

• Compliance Officers and Committees

• Physician Advisors & Medical Directors

• Consultants, Educators, and Trainers

• Practice Managers & Administrators

• Accountable Care Organizations (ACOs)

• Members of Medical Societies and Professional Associations