tci Medicare Compliance & Reimbursement - 2006 Issue 43
PHYSICIANS ~ For Billing Consults, This Is Not The 'Sharing' Season
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Article Overview
This brief physician billing article addresses common misunderstandings about consultation billing under Medicare, especially when services are split among different practitioners in an office setting. It is aimed at physicians, practice managers, and coding/billing staff who need a general understanding of how Medicare policy and CMS guidance affect consult-related billing in physician offices and other settings.
Why This Topic Matters
It helps readers recognize a Medicare billing practice that may not be compliant and understand why consultation claims involving multiple providers require careful policy review.
What You Will Learn
- Common misconceptions about consultation billing in physician practices
- How Medicare and CMS guidance affect shared consult scenarios
- Why office-based shared visits are treated differently from hospital settings
- The role of incident-to rules in office billing contexts
Who Should Read This
- Physicians
- Practice managers
- Medical coders
- Billing staff
- Compliance staff
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