Wiki E/M Services Primary Care Exception

[cperk]

Does the apply to California as well? A provider told me that California didn't have the primary care exception . This is the specific guideline I'm referring to. https://www.cms.gov/files/document/guidelines-teaching-physicians-interns-and-residents.pdf

 

[CBLENNIE]

I don't see anything in this MLN booklet that states California does not have the primary care exception available to eligible facilities/providers.

Can you ask the provider where they are getting their information or what they are basing their determination that it isn't available in California? You might consider printing out the pages of the booklet that are specifically about the E/M Services Primary Care Exception and ask them to show you where they believe the guidelines cause California to not be eligible for the exception.

It could be they saw some small piece of the information or were given a small bit of information by another practitioner on the primary care exception and are interpreting it to mean it is not available in California. By showing them the full list of conditions that must be met to be eligible for the primary care exception they may realize they were wrong and retract their statement.