Split/Shared Visits: CMS Clarifies Split/Shared Visit Rule Now That Consults Are No Longer Payable

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains CMS guidance following the end of Medicare payment for consultation services. It addresses how split/shared visit rules apply to E/M billing, summarizes CMS discussion of inpatient hospital care reporting limits, and notes which bone density test codes should be used under current guidance. The piece is aimed at coders, billers, and compliance staff who work with Medicare physician and hospital E/M claims.

Why This Topic Matters

It helps readers understand how CMS is interpreting Medicare billing rules in areas that were affected by the removal of consult code payment and related operational questions. The article is relevant for reducing claim errors in inpatient care, shared/split services, and diagnostic imaging reporting.

Article Sections

  1. Split/Shared Visits and E/M Billing

    CMS discusses how split/shared visit policies relate to E/M services after consult code payment changes. The section focuses on Medicare guidance and clarification efforts.

  2. CMS Advises Practices to Rein in Initial Inpatient Billing

    This section covers CMS discussion of inpatient hospital care reporting and day-level billing expectations. It addresses questions raised by callers and references current Medicare guidance.

  3. Use Current Bone Density Codes

    CMS comments on bone density test reporting in light of newer code usage and related payment changes. The section contrasts current reporting practices with older test codes.

What You Will Learn

  • How CMS is describing split/shared visit billing in relation to E/M services
  • What Medicare guidance says about initial and subsequent inpatient hospital care reporting
  • Which bone density code set the article says practices should use
  • How CMS is responding to confusion created by recent consultation code payment changes

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance professionals
  • Physician practices
  • Hospital revenue cycle staff

Codes Discussed

  • CPT: 77080
  • CPT: 77082
  • CPT: 76075
  • CPT: 76077

Code Ranges Discussed

  • CPT: 77080--77082

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