decisionhealth Newsletters, Part B News - 1999 Issue 11 (November)
Critical care code change means lower work RVUs
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Article Overview
This article covers a Medicare payment policy update affecting CPT critical care evaluation and management services in the 2000 physician fee schedule. It explains the background of the CPT definition changes, the differing views of HCFA and the AMA, and the broader impact on work relative value units and physician reimbursement. The piece is aimed at physicians, coders, and reimbursement professionals who track E/M policy and fee schedule changes.
Why This Topic Matters
Critical care coding and payment are highly sensitive to definition changes and RVU updates. Understanding the policy context helps practices anticipate reimbursement changes and follow evolving Medicare guidance.
What You Will Learn
- How a CPT critical care definition update affected Medicare physician fee schedule payment policy.
- Why HCFA and the AMA disagreed about the significance of the CPT language changes.
- How the article frames the relationship between critical care and other evaluation and management services.
- What kinds of future review HCFA said it would use to evaluate utilization patterns.
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Reimbursement professionals
- Hospital compliance staff
Codes Discussed
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