Ask Kathy: Physician in same practice can bill consult if criteria met

Article Overview

This Q&A explains a common physician-billing scenario involving a gastroenterologist and a general surgeon in the same practice. It summarizes guidance from a Medicare contractor and focuses on whether a consultation may be reported when one physician requests an evaluation from another physician within the group. The article is useful for physicians, group practices, and coding/billing staff who want a general understanding of consultation billing considerations and the distinction between a consultation request and a referral.