From Exception to Excellence: Governing Primary Care Exception Clinics for Compliance and Performance

The Primary Care Exception (PCE) clinic is a care delivery model approved by CMS that enables resident-led primary care encounters to be billed to Medicare without the constant presence of a teaching physician, as long as specific supervision, service-level, and documentation requirements are followed. This model benefits medical education, improves patient and community access, and promotes financial sustainability, but its success relies on adherence to regulatory guidelines, structural safeguards, disciplined supervision, and ongoing oversight.