The MLN Matters article applies to physicians and non-physician practitioners paid under the Medicare fee-for-service program, and not those under Medicare Advantage or other non-Medicare insurers.
According to the Q&A, providers need to bill the proper E/M code in order to be paid for the E/M services provided, and CMS advises that providers use the E/M code that most closely represents the services provided under the previous CPT code.
The Q&A also includes information on initial hospital codes, services provided under CPT 99499, advance beneficiary notices and new patient office visits.
Read the complete physician consultation code Q&A (pdf).
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
