Wiki Presbyterian no longer paying Consultations

[cgant]

My office just received a letter from Presbyterian Health Plan that states, in short, they will no longer be paying consultation codes 99251-99255 and 99241-99245 per the 2010 Medicare Fee schedule. Physicians are now required to choose an appropriate E/M code based on where the visit occurs/site of service and the complexity of the visit performed. First, has anyone else gotten this letter? Second, would this just be coded with the approriate Office visit codes and H/P codes for hospital? Any insight relating this would be great.

Thanks Much

 

[ajs]

My office just received a letter from Presbyterian Health Plan that states, in short, they will no longer be paying consultation codes 99251-99255 and 99241-99245 per the 2010 Medicare Fee schedule. Physicians are now required to choose an appropriate E/M code based on where the visit occurs/site of service and the complexity of the visit performed. First, has anyone else gotten this letter? Second, would this just be coded with the approriate Office visit codes and H/P codes for hospital? Any insight relating this would be great.

Thanks Much

A lot of commercial payers are following Medicare's lead by no longer recognizing the Consultation codes in CPT. You would bill the appropriate New or Established patient E/M codes based on the site of service. It is happening everwhere and is not a big surprise.