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EM Coding Alert

E/M Coding:

Track Consultation Code Reimbursement Policies

Published on Wed Jun 04, 2025

Question: Providers in my office sometimes perform consultations. We bill these with CPT® codes 99242-99244 but only receive payment sometimes. Am I doing something wrong by using these codes? Pennsylvania Subscriber Answer: The Centers for Medicare & Medicaid Services (CMS) stopped providing reimbursement for codes 99242 (Office or other outpatient consultation for a new or established patient, which requires a [...]
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