DOI: 10.1097/01.NT.0000388097.35649.cc

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Issn Print: 1533-7006

Publication Date: 2010/08/05


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Eliminated CMS Consultation Codes Affect Neurology Bottom Line

Lola Butcher

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Excerpt

Six months after the Centers for Medicare & Medicaid Services (CMS) eliminated consultation codes, the Academy and other medical associations are pressing the government to reconsider.
In a June 18 letter to the CMS, the groups said the elimination of consult codes is hurting some physician practices more than expected.
The financial implication for a practice with at least 50 percent Medicare patients will depend on the patient mix — whether they are new or established patients, simple or complex, and inpatient or outpatient, experts said.
James C. Stevens, MD, a neurologist at Fort Wayne Neurological Center in Indiana, said the new CMS coding rules have resulted in a 15 to 20 percent decline in pay for treating Medicare patients, who comprise about 40 percent of his practice.” That makes it more of a challenge for us to see those patients and make ends meet,” he said.
Indeed, 34 percent of neurologists responding to a survey said they intend to avoid treating patients with complex conditions because of the coding change. The American Medical Association (AMA) developed the survey with input from its member societies, including the AAN.
“This confirms some of our worries about what the effects would be,” said Amanda Becker, the AAN associate director of medical reimbursement.
The AAN, the AMA, and other societies signing the letter are asking the CMS to address the problem in its physician fee schedule rule for 2011.
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