tci Part B Insider - 2010 Issue 1

Consultations: CMS's Refusal to Pay Consults Makes MSP Claims a Headache

Don’t even think about billing a consult to Medicare -- even if it’s only a secondary payer claim. Medicare may have scratched consultations off of its list of payable services, but many other insurers did not follow suit. This leaves you in a quandary when your physician performs a consult and the primary insurer pays you for it, but Medicare is the secondary payer. "Medicare Secondary Payer (MSP) will not pay for consults," says Samantha Daily, billing specialist with Urologic Consultants, PC in Portland, Ore. She points coders toward MLN Matters article MM6740, which indicates the...

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