title: Devaluing a specialty: the Centers for Medicare and Medicaid Services proposal to eliminate consultation codes.
abstract: The Centers for Medicare and Medicaid Services (CMS) has proposed to eliminate payments for the Inpatient and Outpatient Consultation codes beginning on 1 January 2010. The intent appears to be to promote an increase in the supply of primary physicians by increasing payments for other Evaluation and Management services. This will worsen an already inequitable disparity in the payments for complex cognitive services in comparison to procedure-based specialties, to the detriment of infectious diseases physicians. Infectious diseases as a specialty is committed to health care reform that makes sense for both patients and providers. An unintended consequence of the CMS proposal may be that few infectious diseases physicians remain to confront current or future infectious diseases challenges.
authors.affiliation: Consultants in Infectious Diseases, Lubbock, Texas, Lubbock, TX 79407, USA. pusdoc@mac.com
authors.forename: Lawrence P
authors.initials: LP
authors.lastname: Martinelli
authors.forename: Daniel P
authors.initials: DP
authors.lastname: McQuillen
authors.forename: Jason A
authors.initials: JA
authors.lastname: Scull
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D003141:Communicable Diseases / Q000175:diagnosis / Q000628:therapy; D018588:Fee-for-Service Plans / Q000592:standards*; D018166:Health Care Reform / Q000191:economics; D006801:Humans; D011445:Prospective Payment System / Q000191:economics; D012017:Referral and Consultation / Q000191:economics*; D014481:United States