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No-Pay Consult Proposal Could Hit Practices Hard

Published on Mon Aug 24, 2009

Your revenue might go down, but your compliance will be up. If your practice relies on consultations for a good chunk of income, a new CMS proposal for 2010 could wreak havoc. In the July 13 Federal Register, CMS announced a proposal to eliminate payment for consultation codes starting on Jan. 1, 2010. The plan includes non-payment for all inpatient (99251-99255, Inpatient consultation for a new or established patient ...) and outpatient (99241-99245, Office consultation for a new or established patient ...) consultation codes. New way: Instead of reporting consult codes, you will report an initial hospital or an initial nursing home visit or a new or established patient office visit (E/M) code for these services. CMS has proposed plans to increase payments for these codes and other existing E/M codes. This change would "result in a net decrease in allowed charges of approximately $1 billion," noted CMS' Whitney May [...]
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