Consultation payments gone; use new or established visit codes

Why This Topic Matters

The proposed change could alter reimbursement patterns and documentation expectations for practices that frequently bill consultation services, especially in specialty and inpatient settings.

Article Sections

1. CMS proposal to stop paying consultation codes

   Introduces the proposed Medicare policy change and its expected effect on practices that bill consultation services. The section also frames the move in relation to existing evaluation and management visit coding.

2. Payment effects on other E/M services

   Discusses how the proposal relates to other office, hospital, and nursing facility evaluation and management services. It focuses on the general redistribution of payment and the settings most likely to be affected.

3. Documentation and comparison of services

   Summarizes the article’s discussion of documentation burden, work RVUs, and the policy rationale CMS gave for changing consultation payment. It also highlights the broader comparison between consultation services and other E/M services.

4. Consultation definition and transfer of care

   Covers the unresolved definitional issues described in the article, including differences between CMS and CPT guidance. The section addresses the role of transfer-of-care concepts and related ambiguity in consultation policy.

5. OIG findings and official resource

   Notes the referenced Office of the Inspector General report and the article’s pointer to the proposed rule for more information. This section provides context for the policy discussion and where to find the source material.