CMS has proposed new regulations that, as of 2009, would allow physicians to bill Medicare for follow-up inpatient consultations, along with adding 56 new measures to the Physician Quality Reporting Initiative. CMS projects that under the new rule, it would pay $54 billion to 980,000 physicians and other providers next year. If the rules are approved, they'd represent a major moment in the progress of "e-visits," few of which are reimbursed by insurers to date.
Under the proposed rule, CMS would add new codes to its list that would designate consultations done electronically with a patient's attending physician when the consulting doctor wasn't available for an in-person discussion. To make sure hospitals don't worry about using the codes, the rule would give hospitals a safe harbor from self-referral limits. The exception falls under rules allowing payments from hospitals to medical staff members under programs rewarding quality care, such as value-based purchasing programs.
To learn more about the proposal:
- read this Modern Healthcare article (reg. req.)
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