Hospital Consults

When can a Specialist charge for a hospital consult? (99251-99255) for each new admission? Or does the established pt rule come into effect? Would love as much info on this as possible. Appreciate all help and citing!!!

re: Hospital Consults

No consults for Medicare patient. Every new admission where the doc is consulted is billed as Initial hospital visit. There is no new or established as in the office. Same for consults on commercial insurers. First visit is initial consultation, other visits are subsequent visits. If the patient goes home and comes back 2 days later and the same doc is consulted, it is a new Initial visit. But of course most re-consults will say "refer to previous consult" so you should not be seeing high level visits for the second initial visit unless there was a major change on condition.