Billing and Documentation

 View Only
Discussion Thread View
  • 1.  CMS 2023 billing for 99292

    Posted 03-19-2023 11:55

    The 2023 CMS guidelines seem to have changed the definitions for the first critical care hour and first subsequent 30 mins, which in turn effects critical care reimbursement.  We are being told that CMS will not reimburse for the first 99292 until at least 104 minutes are billed.  (So if you docucument / bill 85 minutes, that will only count as a 99291.) Am wondering if anyone has information on this?  Are we misinterpreting the new guidelines? 

    Mary-Margaret Lewis, MD
    PMA Health
    Arlington VA

  • 2.  RE: CMS 2023 billing for 99292

    Posted 03-20-2023 12:37

    This was indeed the recent CMS ruling regarding 99291-2 and happened despite professional organization feedback to the proposal. A challenge to this is currently in the works, coordinated through professional societies. More to come.