Fewer Medicare Patients for Specialists Due to Consult Code Cuts

Cheryl Clark, for HealthLeaders Media , July 19, 2010

As a result, large percentages of respondents say they have changed their practices in the following ways to compensate for the reduced pay:



  • Nearly three in four physicians responding said their Medicare billings had reduced total revenue by more than 5%
  • One in three said revenue is down by more than 15%.
  • One in three has eliminated staff, including physicians in some cases.
  • Three in 10 have reduced services to Medicare patients or are contemplating cost-cutting steps that impact care.
  • Two in five are deferring the purchase of new equipment or information technology.
  • Because CMS no longer requires specialists to provide referring primary care physicians with a written report on the results of the consultation, about 6% have stopped providing these reports, and another 20% plan to stop providing them.


    Survey respondents included members of specialty societies in allergy, asthma and immunology; neurology; otolaryngology; clinical endocrinology; cardiology; gastroenterology; rheumatology; gastroenterology; psychiatry; clinical oncology; gastrointestinal endoscopy; hematology; urology; heart rhythm; infectious diseases; cardiovascular angiography, and endocrinology.

    Mazer shares concerns from many specialists that commercial health plans will also eliminate consult codes, exacerbating the problem.

    In a letter last month to CMS, these 17 specialty societies and another 16 professional physician organizations, said the AMA survey disproves federal officials' contention last year that Medicare revenues would decline by no more than 3%.

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