ASA Urges Fixes to Flawed Medicare Critical Care Payment Policy

ASA has joined with other critical care physician organizations to urge the Centers for Medicare and Medicaid Services to reverse its 2022 policy regarding the billing of subsequent 30 minutes of care following billing CPT code 99291 (critical care, first hour, 30-74 minutes).  In a formal communication coordinated through ASA's Committee on Critical Care Medicine, the organizations jointly urge CMS to return to the pre-2022 policy – a policy consistent with over 20 years of coding guidance and clinical practice.  The pre-2022 policy more accurately reflected the appropriate use and the accurate valuation of critical care services. The flawed new 2022 policy requires physicians to provide 104 minutes of critical care service before they can bill the subsequent 30 minutes of critical care services using CPT code 99292 (critical care, subsequent 30 minutes).