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Consultation codes hurt revenue, AMA study says

Hospitalist Leadership Connection, July 20, 2010

The majority of physicians have lost revenue due to Medicare’s elimination of consultation codes, according to recent survey by the American Medical Association (AMA).

Effective Jan. 1, 2010, CMS no longer reimburses for consultation code bills for Medicare and Medicaid. CMS issued the final rule, asserting that Medicare revenues wouldn’t significantly decline.

The AMA surveyed about 5,500 physician respondents in 17 specialties, collecting data taken in April. The study found:

• 83% of physician respondents said their total revenue stream decreased as a result of Medicare consultation code changes
• 30% modified their practices or services
• 20% reduced the number of new Medicare patients
• 12% reduced the amount of time spent with Medicare patients
• 10% reduced or eliminated consultations on hospital inpatients
• 39% said they will put off purchasing new equipment or information technology
• 34% said they will eliminate staff

Several physician organizations addressed the discontinuation of CPT consultation codes, advocating for CMS to review and revise the 2011 Medicare physician fee schedule rule, in a joint June 18 letter to CMS from organizations, including the American College of Physicians, American Medical Association, and the American Medical Group Association.

“A review of CMS’s current policies regarding physician consultations is clearly called
for,” states the letter. “Revenue losses for consultant physicians are larger than projected. Physicians have been forced to reduce services to Medicare patients and care coordination has suffered as a result of the policy.”

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