E/M RVU Bump Could Benefit Internist
Bummed about consult deletion? Here's why you shouldn't be.
Silver lining:
In the wake of wiping out consult codes, CMS will raise payment for the other E/M codes to offset the consult loss, confirms Quinten A. Buechner, M.S., M.Div., CPC, ACS-FP/GI/PEDS, PCS, CCP, PAHCS, CMSCS, president of ProActive Consultants in Cumberland, Wis.And the impact for internists should be an overall plus, as they provide consultation services far less than most specialists.
"Obviously, this will result in an income increase for primary care specialties, and a decrease for specialists who use consult codes," reports Betsy Nicoletti, MA, CPC, author of The Field Guide to Physician Coding and the president of Medical Practice Consulting in Springfield, Vt.
RVU Rollout Sets 6-Percent Push for OVs
The 2010 Medicare Physician Fee Schedule will increase RVUs for all E/M codes, including:
• 99201-99215 (Office or other outpatient visit for the evaluation and management ...) and
• 99221-99223 (Initial hospital care, per day, for the evaluation and management of a patient ...).
CMS has increased the RVUs for 99201-99215 by about 6 percent and for 99221-99233 by about 2 percent.
For instance, check out the RVU change for 99214 (... a detailed history; a detailed examination; medical decision making of moderate complexity ...): in 2009, its RVUs were 1.42; in 2010, 99214 is worth 1.50 RVUs.
For more information on Medicare's physician reimbursement plans for next year, read "Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2010" at www.federalregister.gov.
3rd Parties Are Mum on Issue So Far
Medicare won't pay for consults in 2010, but private payers have yet to comment officially on the 99241-99255 codes (remember, the code set is in CPT 2010). Practices that want to get the compliance jump can start surveying their commercial carriers to see how they'll want consults coded next year, says Buechner. Many will follow Medicare's lead, but some may still want to see 99241-99255.
