Unintended Consequences of Eliminating Medicare Payments for Consultations

Abstract

In an era of cost control, physician fees are under heavy scrutiny.^1-5 The Medicare Physician Fee Schedule,⁶ which lists the fees that Medicare pays for each physician service under Part B of the program, contains large payment differences between primary care and specialty services. Stemming from the resource-based relative value system, these fee differences have been linked to a substantial income gap between primary care physicians (PCPs) and specialists and to the shortage of medical students entering primary care.^6-12 This has motivated efforts to reform physician payment toward increasing fees for primary care.