Endocrine Insider
December 10, 2009

(See Full Issue)

The Endocrine Society sent a letter to Health and Human Services Secretary Kathleen Sebelius last week asking for a one-year delay in the implementation of the Centers for Medicare and Medicaid Services (CMS) policy to eliminate Medicare billing for inpatient and outpatient/office consultation codes. Despite strong opposition from the Society and other specialty medical groups, CMS has finalized its policy to move forward with the elimination of billing for the codes beginning January 1, 2010.  In place of the eliminated codes, CMS will increase payment for initial hospital stays by 2 percent and new or established office visits by 6 percent. The Society believes that a one-year delay in implementation will help both to educate physicians on the changes this policy will bring and to provide opportunity to gather data on the impact of the changes. A copy of the letter sent to Secretary Sebelius is available here.

Many questions surrounding the implementation of the new policy have been left unanswered, including providing physicians a thorough explanation of which codes to use in place of the eliminated consultation codes. Physicians are also without information on what action third party payers may take in light of the decision that Medicare will no longer pay for these services. CMS intends to release documentation to provide more detail to physicians who will be affected by the changes in billing codes. However, with less than a month before the January 1, 2010 implementation, the lack of details is likely not only to affect physician reimbursement but also to disrupt physician offices.

Members can help in this effort by sending an email to Secretary Sebelius.  The Society has developed a sample letter, which can be edited to reflect specific examples or concerns. 

The Endocrine Society will continue to advocate for fair and reasonable Medicare reimbursement for endocrinology services and will keep its members informed of policy changes that affect them.