Observation Status Consultations

How are we to properly code a consultation level 3 under observation status at a hospital? We are confused as how to differentiate initial hospital care and subsequent hospital care for a consultant under observation status. It used to be 99218. How do we differentiate between Medicare and Medicaid for this coding?

re: Observation Status Consultations

For a consult, you bill with the Outpatient visit codes- new or established, 99201-99215, with place of service outpatient hospital. That is for Medicare and probably Medicaid in most states. Only the admitting doc gets to use the Observation codes.