Part B Insider (Multispecialty) Coding Alert
CMS Official: 'Welcome to Medicare' Not A Problem For Most Docs
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While many physician groups have become vocal in their belief that a level-three office visit won't begin to cover the battery of tests included in the 'Welcome to Medicare' physical, the Centers for Medicare & Medicaid Services isn't yet listening.
"I've probably spoken to several tens of thousands of physicians and office managers since the number became pretty well understood," says a CMS official. "I have not had anybody say to me that they think the payment is too low." While physicians won't "get rich" doing the initial physical exam, it should be affordable to provide them, the official insists.
Separately, don't hold your breath for the final physician Fee Schedule rule to remove the requirement for face-to-face physician visits before prescribing durable medical equipment. In the wake of the massive power wheelchair fraud in Texas and elsewhere, there's a major impetus to crack down on the dishonest docs and vendors. But the policy may change in 2006 if it seems too onerous and some items turn out not to need face-to-face visits.
The CMS official confirmed that Medicare has always paid for consults between members of the same specialty, as long as circumstances warrant. Besides the case of the gastroenterologist-cardiologist consult, there may be one doctor in a rural area who has a particular expertise from which a patient may benefit. Two doctors may share the same specialty, but a patient may have been admitted by the doctor who is less qualified to treat a particular problem.
"We're trusting physicians not to abuse this capability," the CMS official adds, stressing that the circumstances of covering same-specialty consults should be rare.
Separately, a regulation allowing all physicians, instead of a few specialties, to order power operated vehicles for their patients is in the final approval process and should be out soon, the official says.
Part B Insider (Multispecialty) Coding Alert
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CMS Official: 'Welcome to Medicare' Not A Problem For Most Docs
While many physician groups have become vocal in their belief that a level-three office visit [...]