C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 415—SERVICES FURNISHED BY PHYSICIANS IN PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS › Subpart D—Physician Services in Teaching Settings

42 C.F.R. § 415.170

Conditions for payment on a fee schedule basis for physician services in a teaching setting

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Services meeting the conditions for payment in § 415.102(a) furnished in teaching settings are payable under the physician fee schedule if—

(a) The services are personally furnished by a physician who is not a resident; or

(b) The services are furnished by a resident in the presence of a teaching physician except as provided in § 415.172 (concerning physician fee schedule payment for services of teaching physicians), § 415.174 (concerning an exception for services furnished in hospital outpatient and certain other ambulatory settings), § 415.176 (concerning renal dialysis services), and § 415.184 (concerning psychiatric services), as applicable.

Notes of Decisions
Cited in 7 cases (1 in the last 5 years), 2002–2022 · leading case: United States Ex Rel. Smith v. Yale Univ., 415 F. Supp. 2d 58 (D. Conn. 2006).
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United States Ex Rel. Smith v. Yale Univ., 415 F. Supp. 2d 58 (D. Conn. 2006). “See 42 C.F.R. §§ 415.170 (providing that the services must be “personally furnished by a physician who is not a resident” or “furnished by a resident in the presence of a teaching physician”); 415.”
US Ex Rel. Schuhardt v. Washington Univ., 228 F. Supp. 2d 1018 (E.D. Mo. 2002). “42 C.F.R. § 415.170 . Furthermore, 42 C.F.”
Univ. of Med. & Dentistry of New Jersey v. Corrigan, 347 F.3d 57 (3rd Cir. 2003). “” 42 C.F.R. § 415.170 . Because the carriers are initially responsible for enforcing the billing standards, the carriers themselves often issue clarifying instructions to the healthcare providers, furnishing a source of information about Medicare billing requirements in addition…”
Wollman v. Massachusetts Gen. Hosp. Inc. (D. Mass. 2019). · cites it 2× “See 42 C.F.R. §§ 415.170 , 415.172; SAC ¶ 42.”
Wollman v. Massachusetts Gen. Hosp. Inc. (D. Mass. 2018). “42 C.F.R. § 415.170 ; Am. Compl. ¶ 39. Under section 415.”
Doe v. Luketich (W.D. Pa. 2022). “¶¶ 4, 34, 63-64, 69-76 (citing 42 C.F.R §§ 415.170 & 415.172 (“Teaching Physician Regulations”) and 42 U.”
NJ Univ Med. v. Inspector Gen HHS (3rd Cir. 2003). “” 42 C.F.R. § 415.170 . Because the carriers are initially responsible for enforcing the billing standards, the carriers themselves often issue clarifying instructions to the healthcare providers, furnishing a source of information about Medicare billing requirements in addition…”
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