New Medicare Consultation Policy
Earlier this year, the Academy had the opportunity to provide comments on Medicare's proposed consultation policy. Despite this advocacy effort by the AAP and many other medical specialty societies, CMS decided to eliminate use of the consultation codes in the Medicare program starting January 1, 2010. In response to this decision, the Academy has developed a position paper which summarizes the Academy's comments submitted to CMS toward advocating for reconsideration of the Medicare policy. It is important to note that:
In response to the AAP letter advocating for continued payment for consultation codes (CPT codes 99241-99245; 99251-99255) several carriers will continue to pay separately for the codes under their commercial plans: Aetna, CIGNA, Coventry, Harvard Pilgrim Health Care, Humana and UnitedHealthcare. The Centers for Medicare and Medicaid Services (CMS) eliminated payment for the consultation codes under Medicare effective January 1; however, private payers are urged to pay for the consultation codes. The listing of carrier responses and the AAP letter are posted on the PPA Web page (member login required).