Consultation codes

Medicare Advantage

 

Consultation codes will no longer be allowed for Anthem Blue Cross and Blue Shield for Medicare Advantage. This determination aligns with CMS guidance and does not allow reimbursement for inpatient (99251-99255) or outpatient (99241-99245) consultation codes and requires providers to bill the appropriate office visit evaluation and management (E/M) code for consultation services.

 

MULTI-BCBS-CR-005933-22-CPN5916