CMS is recognizing six codes for interprofessional consults in 2019.
Four of these were existing codes that did have a status indicator of bundled and now have a status indicator of active, indicating payment by Medicare.
Two are new CPT codes, also with an active status indicator.
Consulting without seeing the patient
These six codes describe assessment and management consultative service provided by phone, internet or electronic health record when the patient’s treating physician/ non-physician practitioner (NPP) requests an opinion and/or treatment advice of a consulting physician/NPP. The consulting physician/NPP has specific specialty expertise to assist in the diagnosis and/or management of the patient, without a face-to-face visit.
These are all time-based codes.
- The first five are for use by the consulting clinician.
- The sixth is for the use of the treating physician, NP or PA.
The values in the chart below are for 2019. The conversion factor is $36.04
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