CMS Issues Additional Guidance Regarding Elimination of Consultation Codes

As HLP previously reported, in December, CMS issued MLN Matter 6740 announcing that consultation codes would no longer be used to reflect the different locations where services were provided.

This week, CMS issued additional guidance regarding billing for those services that would previously been coded as consultations. This guidance includes a Questions and Answers on Reporting Physician Consultation Services and Revisions to Consultation Services Payment Policy.

The “Questions and Answers” document includes a wide range of information, including how to bill for services that don’t fit classification by a CPT E/M code, how this change affects the definition of transfer of care, how to define new versus existing patients, and whether providers can bill patients for services denied by Medicare for the reason that the incorrect CPT code was billed.

For more information, contact Abby Pendleton, Esq. at (248) 996-8510.

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