How to billing hospital consultation service

New Medicare Coding for Consultation Services


Crosswalks for Emergency Department Consultations requiring admission of patient into inpatient facility
CPT Consultative Services Code CPT E/M Codes for Crosswalking Modifier Required
99251 99221 (Inpatient Initial Visit, level 1) Yes, you will need to append Modifier “AI”
99252 99221 (Inpatient Initial Visit, level 1) or
99222 (Inpatient Initial Visit, level 2)
Yes, you will need to append Modifier “AI”
99253 99222 (Inpatient Initial Visit, level 1) Yes, you will need to append Modifier “AI”
99254 99222 (Inpatient Initial Visit, level 2) or
99222 (Inpatient Initial Visit, level 3)
Yes, you will need to append Modifier “AI”
99255 99223 (Inpatient Initial Visit, level 3) Yes, you will need to append Modifier “AI”






Crosswalks for Inpatient Consultations
CPT Consultative Services Code CPT E/M Codes for Crosswalking Modifier Required
99251 99221 (Inpatient Initial Visit, level 1) Yes, referring physician (not you)
will need to append Modifier “AI”
99252 99221 (Inpatient Initial Visit, level 1) or
99222 (Inpatient Initial Visit, level 2)
Yes, referring physician (not you)
will need to append Modifier “AI”
99253 99222 (Inpatient Initial Visit, level 1) Yes, referring physician (not you)
will need to append Modifier “AI”
99254 99222 (Inpatient Initial Visit, level 2) or
99222 (Inpatient Initial Visit, level 3)
Yes, referring physician (not you)
will need to append Modifier “AI”
99255 99223 (Inpatient Initial Visit, level 3) Yes, referring physician (not you)
will need to append Modifier “AI”

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