MAY 13, 2021
Billing Consultation Codes When Medicare is Secondary
Question: A new patient comes to us as a request for a consultation, code family 99241-99245. The primary insurance is a commercial plan that recognizes consultation codes. Medicare Part B is the secondary insurance. Can we bill a consult code?
Answer: You can. However, Medicare Part B will not pay for this family of CPT codes because they no longer recognize them and haven’t since 2010. You can’t collect from the patient, so ultimately, you’ll be paid less. Best to submit the appropriate level of E/M code 99202-99205.