The information in this article applies to services provided on and after January 1, 2023.
Although no longer paid by some payers, Current Procedural Terminology (CPT®) 2023 retains codes for reporting consultations and the Centers for Medicare & Medicaid Services publishes values on the Medicare Physician Fee Schedule. The prefatory text to the consultation codes provides the following definition of a consultation that helps to differentiate the service from other E/M services:
There are 2 important aspects of the definition of a consultation.
For those services that meet the definition of a consultation service, there is an additional requirement that the physician or QHP performing the consultation must provide a written report including the opinion on care for the specified condition or problem and any services that were ordered or performed. The written report may be delivered via hard copy or electronically, including access by a...