In the proposed changes to the Hospital Outpatient Prospective Payment System, CMS is proposing to change the physician supervision requirements applicable to hospital outpatient services described in the 2009 Hospital Outpatient Prospective Payment System (OPPS) final rule. In the proposed rulemaking release, issued July 1, 2009, CMS indicates that physician supervision requirements requiring "direct supervision" will be met so long as the supervising physician is physically present on the hospital campus and immediately available to offer assistance during the service. This is similar to the "incident to" direct supervision requirement, but the question will continue to be the definition of "Hospital Campus" when combined with "immediately available." CMS also indicates that non-physician practitioners can satisfy supervision requirements consistent with their state-defined scope of practice.