Steer clear of shared consultations for Medicare

Why This Topic Matters

Shared or split-service arrangements can affect whether a visit is payable under Medicare and how documentation is reviewed. Understanding the policy helps practices reduce billing errors and align consultation workflows with Medicare requirements.

Article Sections

1. Medicare consultation policy and carrier guidance

   This section summarizes Medicare’s general stance on consultation billing and highlights guidance from Medicare carriers and CMS resources. It also notes the timing of policy changes and the types of documentation issues being monitored.

2. Resources

   This section points readers to external CMS and Medicare contractor materials related to consultation billing and shared-service policy.

3. Shared visits: Rules differ based on site of service

   This section outlines how shared or split evaluation and management visits are treated differently depending on whether the service occurs in the office or in the hospital. It distinguishes between broad categories of visit types and settings without going into code selection detail.