CMS Manual System

CMS Manual System Department of Health & Human Services (DHHS) Pub 100-04 Medicare Claims Processing Centers for Medicare & Medicaid Services (CMS) transmittal 1875 Date: December 14, 2009 Change Request 6740 SUBJECT: Revisions to Consultation Services Payment Policy I. SUMMARY OF CHANGES: In the calendar year 2010 physician fee schedule final rule with comment period (CMS-1413-FC) CMS budget neutrally eliminated the use of all consultation codes (inpatient and office/outpatient codes) for various places of service except for telehealth consultation G-codes. CMS increased the work relative value units (RVUs) for new and established office visits, increasing the work RVUs for initial hospital and initial nursing facility visits, and incorporating the increased use of these visits into our practice expense PE and malpractice calculations. CMS also increased the incremental work RVUs for the evaluation and management (E/M) codes that are built into the 10-day and 90-day global surgical codes.

for the evaluation and management (E/M) codes that are built into the 10-day and 90-day global surgical codes. All references (both text and code numbers) in IOM Publication 100-04 (CP), Chapter 12 §30.6 that pertain to the use of the AMA CPT consultation codes (ranges 99241-99245 and 99251-99255) are removed by this transmittal.

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  Evaluation, Transmittal

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