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Supervision CMS 2 issues instructions specifying that diagnostic tests must “… be performed under the supervision of an individual meeting the definition of a ‘physician’ to be considered reasonable and necessary and, therefore, covered under Medicare.” 3 Medicare has established three different levels of physician supervision, commensurate with the risk to the patient and/or the skills required to obtain useful results: General supervision, which means the procedure is furnished under the physician’s overall direction and control, but the physician’s presence is not required during the performance of the procedure