Medicare Compliance & Reimbursement - 2008 Issue 2
Reader Question: 'Team Conference' Isn't Separately Reportable
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Article Overview
This reader Q&A discusses a physician-led team conference involving multiple health professionals and whether it is separately billable. It outlines the CPT framework, Medicare payment guidance, and the possibility that private payers may follow different policies. The article also notes an upcoming CPT code set change that could affect how these services are reported in the future.
Why This Topic Matters
It helps coders, physicians, and billing staff understand whether interdisciplinary care conferences are separately reportable and why payer-specific rules matter for compliance and claim submission.
Article Sections
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Question
A reader describes a physician-led meeting with multiple specialists to discuss patient care when the patient is not present and asks whether the service is billable.
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Answer
The response summarizes CPT and Medicare guidance for physician team conferences and notes that payer policy may differ.
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Change is coming
The article closes with a brief note about anticipated CPT code set changes affecting this topic in a future year.
What You Will Learn
- How physician team conferences are addressed in CPT and Medicare guidance
- Why payer policy can affect whether a service is separately reported
- What types of future code set changes may be relevant to this topic
- How case management considerations relate to broader E/M service selection
Who Should Read This
- Medical coders
- Billing staff
- Physicians
- Practice managers
- Compliance professionals
Codes Discussed
Code Ranges Discussed
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