specialty codes for Cardiac Electrophysiology

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Specialty Code for Cardiac Electrophysiology

The Heart Rhythm Society has successfully advocated for a unique CMS physician specialty code for cardiac electrophysiology from the U.S. Centers for Medicare and Medicaid Services (CMS). This new physician specialty code is a major achievement for the Society and the field of electrophysiology as a whole.

The following letter was sent to Heart Rhythm Society member on December 1, 2010.

Electrophysiology Acquires a Medicare Physician Specialty Designation Code

Dear Heart Rhythm Society Member,

Earlier this year, the Heart Rhythm Society submitted a priority request to the Centers for Medicare and Medicaid Services (CMS) for a separate physician specialty code in electrophysiology, reflecting its distinction from other specialties. We are delighted to announce that cardiac electrophysiology has received this valuable recognition. This separate specialty code solidifies the distinction of electrophysiologists from other physicians to provide highly specialized, quality heart rhythm care.

On November 22, CMS issued the Physician Specialty Codes for Cardiac Electrophysiology and Sports Medicine Document (PDF, 56K) and designated physician specialty code number 21 for cardiac electrophysiology. Since the establishment of the specialty code will require changes to the CMS enrollment and claims processing systems, this new designation will not be implemented until April 4, 2011.

This new physician specialty code is a major achievement for the field of electrophysiology. It will allow CMS to more accurately measure use of physician resources and track patient treatment across episodes of care. Currently, there is no mechanism for CMS to accurately report on this category of physicians. The new specialty code will provide a mechanism to distinguish an electrophysiologist from a cardiologist when billing for Medicare services. For example, in the past, some local Medicare carriers have denied claims, citing duplicate billing, when a cardiologist and an EP from the same group practice billed consultation new patient evaluation services. The electrophysiology specialty code will allow for the reporting of the involvement of two specialty physicians providing distinct services to an individual patient.

Sincerely,


Douglas L. Packer, MD, FHRS President Heart Rhythm Society	Richard L. Page, MD, FHRS Immediate Past President Heart Rhythm Society