Mid level providers (NPPs) consultation rules

Hello,
I have about 15 NPPs and they've been told in the past that unless a consult request from a PCP is directed specifically for them, they cannot bill a consult. I think if a PCP requests the advice of any provider in our group (as a group, i.e. go see someone at ________ and have them report back to me) it can be coded as a consultation. Does anyone have the rules on this issue?
thank you.

consult request

A written request for a consultation from an appropriate source and the need for a consultation must be documented in the patient’s medical record. The initial request may be a verbal interaction between the requesting physician and the consulting physician; however, the verbal conversation shall be documented in the patient’s medical record, indicating a request for a consultation service was made by the requesting physician or qualified NPP.
The reason for the consultation service shall be documented by the consultant (physician or qualified NPP) in the patient’s medical record and included in the requesting physician or qualified NPP’s plan of care. The consultation service request may be written on a physician order form by the requestor in a shared medical record. Consultation - An E&M service provided by a physician whose opinion or advice of a specific problem is requested by another physician or other appropriate source.
Know what the requesting MD intended. If the requestor intended an MD to perform the service because of advanced skills, it may be a problem for the PCP to have a NPP perform the service (if within scope of practice). The NPP would receive reduced payment.

NPP consults

Would this then also apply to physicians? We have groups and PCP's that refer to our group for consultations. The physicians code consultations so why would the NPP's not be able to?
thank you

NPP consults

I think in large groups, that a request to Cardiology or Pulmonary Medicine, without naming a specific physician does constitute a consult. There are times when the referring physician may want one particular physician's opinion, times when they want any qualified sub specialty or general Cardiologist to assess teh patient. I think you can still bill a consult.

The office should work to make sure that the patient gets to the right provider the first time.

Of course, consults are no longer an issue for Medicare. I would read the CPT section at the start of the consults area if I were you. I don't think that you'll find anything that prohibits assigned the patient to the most appropriate/most convenient practitioner.

Finally, look at the requests from office: do they support the consult to anyone "Consult Cardiology for XYZ" or not?