Medicare Approves Virtual Direct Supervision

It’s official - In the CY 2026 Medicare Physician Fee Schedule Final Rule, CMS has announced that direct supervision may now be provided permanently through real-time, two-way audio/visual telecommunications (video required—audio-only does not qualify).

What this Means

For services that require direct supervision - traditionally meaning the physician must be “immediately available” and physically present in the office suite - Medicare will now allow supervising physicians and qualified practitioners to meet those requirements virtually, as long as they are immediately available via live audio-visual technology.

CMS also emphasizes that even though virtual supervision is allowed, clinicians must continue to rely on their professional judgment to determine whether virtual or in-person supervision is most appropriate based on the patient, service, and clinical circumstances.

This update is a big win that expands access to care, supports modern practice operations, and provides long-needed flexibility for outpatient specialty clinics.