Healthcare Business Management Association - HBMA
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Medicare Consult Guidelines
By Jackie Miller, RHIA, CCS-P, CPC, PCS

In 2010, the Centers for Medicare and Medicaid Services (CMS) adopted new billing guidelines for consultations. This decision was the culmination of many years of struggle by CMS to ensure accurate Medicare payment for consults. In a 2006 audit report ("Consultations in Medicare: Coding and Reimbursement"), the HHS Office of Inspector General estimated that in 2001, Medicare made overpayments of approximately $1.1 billion for consultation services...

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