Wiki Medicare and Consult E/M's (99242, 99243, 99244)

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Stacey Walden

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Hi all,

Just wanting to get some clarification. Does medicare not cover consults? We cannot get them to pay.

Thank you!
 
After further review...

Went on Novitas' website and it appears they actually do not cover consults! Let me know if anyone has heard otherwise.
 
No they do not cover 99241-99245. Use new or established E/M codes (99201-99215)

Nor do the cover 99251-99255 (use initial or subsequent inpatient hospital codes)
 
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