Urging Changes to Proposed Critical Care Billing Policy

February 6, 2024

In response to the 2025 Medicare Physician Fee Schedule proposed rule from the Centers for Medicare & Medicaid Services (CMS), the American College of CHEST Physicians (CHEST) joined with other medical associations to share comments advocating on behalf of their clinician members.

In the letter, CHEST and other groups urged CMS to revise its policy regarding billing for “99292 – critical care, subsequent 30 minutes” to the billing policy established prior to 2022.

Under the proposed policy, physicians would need to provide 104 minutes of critical care service (30 minutes longer than previous policies) before they can bill the first unit of 99292. This policy change would devalue the work of physicians under code 99291 (critical care, first hour, 30-74 minutes) by 30%, which is highly concerning and considered to be unfair to critical care providers.

Read the full letter to CMS.