In an office setting, direction and management of a medical procedure given by the physician. The doctor must be present in the office suite and available to give assistance and instruction during the performance of the procedure. The doctor does not need to be present in the room when the procedure is performed. Some medical procedures require direct supervision to bill for a specific level of service. This level of supervision is required when billing for “incident-to” services in an office setting. Also see general supervision and personal supervision .