Billing Medicare Patient Admittance

Billing Medicare Patient Admittance

September 7, 2017

Question:
I was consulted to see a Medicare patient in the emergency room (ER) by the Emergency Department physician.  When I arrived, the patient was still in the ER but had been admitted to the hospitalist and was waiting for a bed.

Answer:
Since the patient is Medicare and has been formally admitted you would report CPT codes 99221-99223 for this consultation service, even though the patient is physically in the ED. Keep in mind Medicare does not pay for inpatient or outpatient consultations.

*This response is based on the best information available as of 09/07/17.

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