The Centers for Medicare and Medicaid Services (CMS) has developed a new specialty code in electrophysiology to reflect its distinction from other specialties.
The Heart Rhythm Society played a critical role in getting the new designation, which will allow CMS to distinguish an electrophysiologist (EP) from a cardiologist when billing for Medicare services. Up until now there has been no mechanism for CMS to accurately report on this category of physician and some local Medicare carriers have denied claims, citing duplicate billing, when a cardiologist and an EP from the same group practice have billed for patient evaluation services. The new code will now allow for the reporting of the involvement of two specialty physicians providing distinct services to an individual patient.
Since the establishment of the specialty code will require changes to the CMS enrollment and claims processing systems, this new designation will not be implemented until April 4, 2011. The ACC will be working with the Heart Rhythm Society in the coming months to provide more detailed information on the enrollment process, as well as information on coding and reimbursement.