Beginning in October 2019, two major commercial payers, UnitedHealthcare and Cigna, discontinued payment for consultation services. The CPT codes affected include 99241–99245 and 99251–99255. The payers have instructed providers to instead bill the non-consultative evaluation and management (E/M) codes that best describe the services performed. If the non-face-to-face service goes beyond the usual time a…
The Important Role of the AMA RVS Update Committee in Medicare Payments
Believe it or not, change begins with one person willing to lead by example—and you can be that person. All too often, we get caught up with the changes we want. However, instead of talking about what we would like, it’s time to lead. The best way to do this is to show others you’re…
A Look at CPT Codes for Prolonged Services
In the 2017 Medicare physician fee schedule, the CMS officially activated CPT codes 99358 and 99359 as reimbursable codes for non-face-to-face prolonged services performed in the office or outpatient setting, hospital or nursing facility by physicians or other qualified health practitioners (not clinical staff). The CPT codes are defined as 99358: Prolonged evaluation and management service…