Requestor and receiver must document consult request

Why This Topic Matters

Medicare’s documentation requirements can affect whether a service is billed as a consultation or as another visit type, which has compliance and audit implications for practices.

Article Sections

1. Medicare consultation documentation changes

   Introduces the policy update and explains why consultation documentation became a focus under Medicare guidance.

2. Written request and medical record documentation

   Summarizes the documentation expectations for consultation requests and notes how the requirements are described for the medical record and related communication.

3. Transfer of care versus consultation

   Describes the policy language that distinguishes a consultation from a transfer of care and discusses the reporting implications at a general level.

4. Group practice and shared record considerations

   Covers how documentation is addressed when physicians share a medical record or work within a group setting.

5. Practical concerns for specialty practices

   Discusses the article’s specialty-practice context and the compliance concerns that arise when consultation documentation is reviewed by Medicare carriers or auditors.