AMA issues new consult rules for payers that still cover

Why This Topic Matters

Consultation coverage is changing among payers, so understanding the current CPT guidance helps practices report these services appropriately while coverage remains available. The article is relevant for avoiding unnecessary abandonment of consult reporting and for keeping pace with payer policy shifts.

Article Sections

1. Consultation coding guidance and payer coverage context

   Introduces the updated AMA consultation guidance and explains why coverage policies among payers matter to practices that still bill these services.

2. Transfer of care and consultation reporting examples

   Summarizes how the article frames transfer-of-care situations versus consultation reporting and includes a broad illustrative example.

3. AMA consult and visit code recommendations for outpatient and inpatient services

   Presents the AMA’s comparison of consultation and visit categories for outpatient and inpatient settings, including related reporting groupings.