Physicians should note that this article clarifies and corrects the definition of "new patient" and "physician in a group practice" for billing evaluation and management (E/M) services and updates the policy on billing E/M services with drug administration codes in the Medicare Claims Processing Manual. Previously, Change Request (CR) 3631 instructed carriers not to allow payment for Current Procedural Coding Terminology (CPT) code 99211 if billed with a drug administration service, such as chemotherapy or non-chemotherapy drug infusion code. In the Medicare Physician Fee Schedule Final Rule published on November 15, 2004, this policy was expanded to include therapeutic and diagnostic injection codes.

The entire Medicare Learning matters article for this Change Requset (CR4032) is available at www.cms.hhs.gov