MSP has recently announced new GIM (General Internal Medicine) Fee codes for General Internists. The new GIM codes only apply to General Internists who have completed 3 years of core Internal Medicine training, plus at least 1 full year of General Internal Medicine training.
There are 3 distinct categories for GIMs (General Internal Medicine Specialists). The new codes are only applicable to Category 2.
| Category 1 | Category 2 | Category 3 |
|---|---|---|
| GIMs who have less than 4 years of GIM training. | GIMs with 4 years or more of GIM training. | GIMs only (i.e., no sub-specialty) For Complex Patients. |
It’s crucial to make sure you know exactly what you can and cannot bill. Billing properly, and accurately, is extremely important in order to avoid penalties while at the same time maximizing earnings. In order to make things easier, we’ve outlined each GIM category and the relevant billing codes and fees that go along with them.
The following codes are effective as of October 1, 2018.
Category 1
GIMs who have less than 4 years of GIM training can bill the following fee codes:
| Code | Explanation | Fee |
|---|---|---|
| 00312 | Repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant the consultative services do not warrant a full consultative fee | $80.37 |
| 00310 | To consist of examination, review of history, laboratory, X-ray findings, and any additional visits necessary to render a written report. | $166.35 |
Continuing care by consultant:
| 00308 | Subsequent Hospital Visit | $28.71 |
Telehealth Service with Direct Interactive Video Link with the Patient:
| 32270 | Telehealth Consultation: To consist of examination, review of history, laboratory, X-ray findings, and additional visits necessary to render a written report. | $166.35 |
| 32272 | Telehealth repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant, the consultative services do not warrant a full consultative fee. | $80.37 |
| 32276 | Telehealth Directive Care | $71.32 |
| 32277 | Telehealth Subsequent Office Visit | $49.71 |
| 32278 | Telehealth Subsequent Hospital Visit | $28.71 |
Category 2
GIMs with 4 years or more of GIM training can bill the following NEW fee codes:
| Code | Explanation | Fee |
|---|---|---|
| 32210 | To consist of examination, review of history, laboratory, X-ray findings, and any additional visits necessary to render a written report. | $202.57 |
| 32212 | Repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant the consultative services do not warrant a full consultative fee | $90.00 |
Continuing Care by consultant:
Telehealth Service with Direct Interactive Video Link with the Patient:
Category 3GIMs ONLY (i.e., no sub-specialty) For Complex Patients can bill the following fee codes (see below for a list of chronic diseases).32308 is payable only to admitted patients and only if it’s paid within the previous 6 months. 32308 is also payable for ongoing inpatient follow up care, for each day hospitalized during the first ten days of hospitalization, (thereafter, you’ll bill 00308).The total of all daily billing under this fee item that are accepted for payment by MSP will be calculated for each practitioner for each calendar day. Daily totals will be paid as follows: 1-15 visits paid at 100%
16 or more visits paid at 50%.Note: Fee Codes 00311, 32271, 32307, and 32308 (Category 3) are payable with a written consultation report that includes advice or recommendations for treatment, regarding 3 or more of the following conditions:
Exceptions to this rule can be made if the patient has two diagnoses from this list and one alternative diagnosis not on this list. If that is the case, it has to be submitted with correspondence/note records, outlining the medical necessity. Each case will be reviewed on an independent consideration basis.If you have any questions regarding GIM codes, please don’t hesitate to contact our team here.
| 32206 | Directive Care | $85.00 |
| 32208 | Subsequent Hospital Visit | $50.00 |
| 32370 | Telehealth Consultation: To consist of examination, review of history, laboratory, X-ray findings, and additional visits necessary to render a written report. | $202.57 |
| 32372 | Telehealth repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant, the consultative services do not warrant a full consultative fee. | $90.00 |
| 32376 | Telehealth Directive Care | $85.00 |
| 32378 | Telehealth subsequent hospital visit | $50.00 |
| Code | Explanation | Fee |
|---|---|---|
| 00311 | Complex Consultation – Payable for patients that have 3 or more chronic diseases. For hospital in-patients, paid once per patient per hospital admission. | $263.52 |
| 32271 | Telehealth Complex Consultation – Payable for patients that have 3 or more chronic diseases. Limited to one per patient in a 6-month period. | $263.52 |
| 32307 | Subsequent follow-up office visit, complex patient – 3 medical conditions. Payable only if 00311 is paid within the previous 6 months. | $90.00 |
| 32308 | Subsequent Hospital Visit, Complex Patient – 3 Medical Conditions. | $53.00 |
| Disease | Diagnostic Code | |
| Coronary Atherosclerosis | 414 | |
| Septicemia | 038 | |
| Other HIV Infection | 044 | |
| DM including complications | 250 | |
| Disorders of Lipid Metabolism | 272 | |
| Thyroid disorders | 246 | |
| Purpura, Thrombocytopenia and Hemorrhagic conditions | 287 | |
| Anemia, unspecified | 285.9 | |
| Senile Dementia, Presenile Dementia | 290 | |
| Acute Confusional State | 293 | |
| Congestive Heart Failure | 428 | |
| Diseases of the Aortic and Mitral valve | 396 | |
| Essential Hypertension | 401 | |
| Neoplasm of uncertain behaviour of other and unspecified sites. “Not for minor or superficial skin malignancies.” | 238 | |
| Cardiac Dysarrhythmias | ||
| Cerebral Atherosclerosis | 437 | |
| Asthma Allergic Bronchitis | 493 | |
| Emphysema | 492 | |
| Other Bacterial Pneumonia | 482 | |
| Non Infective Enteritis and Colitis | 557.1 | |
| GI Hemorrhage | 578 | |
| Chronic Liver diseases and Cirrhosis of the Liver | 571 | |
| CRF | 585 | |
| ARF | 584 | |
| Systemic Lupus Erythematosus | 710 | |
| Disorders of fluid, electrolyte and acid base balance | 276 | |
| Syncope | 780.2 | |
| cell1_3 | cell2_3 | |
| Venous thrombosis and embolism | 453 | |
| Pulmonary fibrosis | 515 | |
| Rheumatoid Arthritis | 714 |
This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.
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