CMS: Consult change is final; new modifier to be released any day

Why This Topic Matters

It matters because it addresses a major Medicare payment and coding transition that affects how practices report evaluation and management services and prepare for policy and workflow changes. The article also highlights associated administrative and reimbursement issues that may influence payer behavior and practice operations.

Article Sections

1. CMS confirms consult change and forthcoming modifier

   Overview of CMS’s position on the consult policy transition and the expected release of related guidance. The section frames the timing and general operational context for the change.

2. PPAC discussion of billing and coding transition issues

   Discussion of questions raised about the move from consult billing to other visit reporting structures. The section addresses broad implementation concerns, including crosswalking and payer coordination.

3. PPAC recommendations to CMS

   Summary of several policy recommendations submitted by PPAC to CMS. The section covers proposed changes touching physician payment, enrollment processes, and resource-use feedback.