Health Care Alert: Incentive Payments Available for Geriatric Medicine Services


Geriatric medicine is among the delineated services for which the rendering physician or non-physician practitioner (NPP) is eligible to seek up to a 10 percent incentive bonus from Medicare, paid on a quarterly basis, for service provided from January 1, 2011 through January 1, 2016. “Incentive Payments for Primary Care Services” were added to the Medicare law through Section 5501(a (2)(A) of the health care reform legislation, the Patient Protection Affordable Care Act or PPACA, to encourage a shift from specialist to primary care physician (and non-physician practitioners or NPPs including nurse practitioners, certain clinical nurse specialists, and physician assistants) services. Primary care services that qualify for the incentive payment calculation are services billed under the following codes:

- 99201 through 99215 for new and established patient office or other outpatient Evaluation and Management (E/M) visits;

- 99304 through 99340 for initial, subsequent, discharge, and other nursing facility E/M services; new and established patient domiciliary, rest home (e.g., boarding home), or custodial care E/M services; and domiciliary, rest home (e.g., assisted living facility), or home care plan oversight services; and

- 99341 through 99350 for new and established patient home E/M visits.

Please see full alert below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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