READER QUESTIONS:
Brace for Potential End to 99241-99255
Published on Wed Aug 26, 2009
Question: I'm hearing that consultation codes may go away in 2010. How could this affect my practice? Pennsylvania Subscriber Answer: CMS has proposed ending coverage of consultation codes 99241-99255 to increase payments for primary care services, according to the new Medicare Physician Fee Schedule proposals, printed in the July 13 Federal Register. The AMA does, however, plan on maintaining the codes at least for CPT 2010. What to do: For Medicare and private payers that adopt Medicare's consultation coverage change, you would use E/M codes (99201-99215 for office visits or 99221-99223 for hospital care), rather than consultation codes (99241-99245 for outpatient consults and 99251-99255 for inpatient consults). The proposed rule suggests redistributing the savings that would result from invalidating consultation codes into payments for E/M services, such as office visits (99201- 99215, Office or Other Outpatient Services) and initial hospital care (99221-99223). CMS would still leave the values on 99241-99245 [...]