Revisions to Consultation Services

Payment Policy

NEW 1/6/10: The Alameda/Contra-Costa County Medical Association (ACCMA) is offering a webinar on "Billing for Medicare Consultations" and making a decision on “Participation” given by Mary Jean Sage on Wednesday January 13 from 12:30 until 1:45pm.  They will give SCCMS members the ACCMA member’s rate of $25.00.  See the ACCMA webinar flier for details.

Also, the CMA produced a 4 page document on the the consultation code topic.  See the CMA Consultation Code Crosswalk.

1/4/2010: New documents from Sandra Siddall from PalmettoGBA. First is an 8 page PDF dated 12/14/09 titled "Revisions to Consultation Services Payment Policy". Second is a document dated 12/18/09, with "J1 Consultation Codes Article".

12/16/09: Released by CMS on December 15, 2009 is a 29 page document which provides greater detail on the new policy prohibiting billing for CPT consultation codes and describes how consults should be billed to Medicare.  According to CMS officials, no decision was made regarding the AMA's request that this policy be delayed for a year.  However, the agency thought that it needed to proceed to issue the transmittal in the event that the policy is not delayed. There might be an amendment to the Senate health reform bill that would delay the policy for one year and instruct CMS to work with CPT to modify or replace existing consult codes during that time.

Revisions document (PDF)

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