Medicare's decision to eliminate consultation codes has resulted in a loss of revenue for many physicians and forced some to cut back on appointments with Medicare beneficiaries, according to a survey commissioned by the American Medical Association and several other medical specialty societies.
“Rheumatic diseases are complex, chronic, debilitating, and oftentimes life threatening, and specialized care from a rheumatologist is essential to the livelihood of people with rheumatic diseases,” Dr. Stanley B. Cohen, president of the American College of Rheumatology, said in a statement. “By removing consultation service codes, CMS is stating that the … unique specialty care provided by rheumatologists is not valued.”
CMS argues that the billings by primary care physicians and specialists are identical except the consultant sends a report to the requesting physician.
“When we [rheumatologists and other specialists] are asked to see a patient on referral, it is because the case is complicated, and the referring physician could not figure out the diagnosis. We are sought out for our extra training to assess the problem and develop a good care plan,” said Dr. Karen S. Kolba, a rheumatologist in private practice in Santa Maria, Calif.
In an online survey of about 5,500 physicians, about 730% reported that not being able to bill for consultations had decreased their total revenues by more than 15%.
The loss of revenue has in turn impacted physicians' practices: 20% of respondents said they have already reduced the number of new Medicare patients seen in their practices, and.39% said they will hold off on purchasing new equipment or health information technology.
In addition, about 6% of responding physicians said they have stopped providing primary care physicians with written reports following consults with Medicare patients, and another 19% said they plan to do so.