Implementing an Interprofessional Consult Model to Support Documentation of and Reimbursement for Curbside Consultations
Caitlin Naureckas Li, Taylor Heald-Sargent, Kathleen Murtagh, Erin Claussen, Ravi JhaveriAbstract
Background
Infectious Diseases (ID) clinicians are frequently asked to provide “curbside” consultations to support the care of patients they do not see personally. ID services frequently do not receive financial compensation for this cognitive burden.
Methods
We worked with our hospital billing and informatics teams to set up a process for infectious diseases clinicians to use CPT codes 99446-99449 to bill for advice provided via telephone to clinicians in other specialties. An “interprofessional consult” (IPC) note template was built to support the billing requirements for these codes that included disappearing text with billing instructions. Education was provided to clinicians at our standing division meeting, with follow-up written materials provided via email. Clinicians were regularly provided with feedback regarding the number of IPCs completed and insurance reimbursement.
Results
Between May 2024 and November 2024, our division has completed 53 IPCs. Of the 39 that have entered the revenue cycle, 18 (46.2%) were for patients with Medicaid, 18 (46.2%) for patients with private insurance, and 3 (10.3%) for patients with other insurance statuses. Of those that have completed the revenue cycle, 15/26 (57.7%) were reimbursed by insurance and 11/26 (42.3%) received no reimbursement. The median reimbursement was $48.53 by Medicaid and $153.67 by commercial insurance. For comparison, the same providers received a median reimbursement for an initial inpatient consultation with a high level of medical decision making of $87.10 by Medicaid and $588.17 by commercial insurance.
Conclusions
Our early implementation experience suggests that interprofessional consults can be successfully implemented to support compensation for advice provided by ID clinicians to their peers over the phone.