Modern Healthcare (3/21, Tepper, Subscription Publication) reports, “Health insurers Anthem and Aetna began denying [healthcare professionals’] claims that include consultation codes this year, joining the growing ranks of payers cutting reimbursement amid an industrywide coding change.” In 2010, “Medicare stopped paying claims that include consult codes,” and “now, more insurers are following the Centers for Medicare and Medicaid Services’ lead and requiring [healthcare professionals] to use different codes to bill for consultations.” In 2019, “UnitedHealthcare stopped recognizing these codes…in an effort to align with federal practices,” implementing “the policy after facing pushback from groups such as the… American Psychiatric Association, which complained the change undervalued their members’ services.”
Related Links:
— “More insurers cut payment for patient consultations “Nona Tepper, Modern Healthcare, March 21, 2022