Rush to higher-paying codes

Hospital billing of the two most expensive emergency room codes — 99284 and 99285 — jumped while less expensive codes — 99281 through 999283 — dropped off. The billing codes represent the varying levels of hospital resources required for different types of care; the codes call for payments ranging from $50 to $324, and come on top of physician fees. The codes were developed for physicians, not hospitals. Yet Medicare’s administrator has balked at implementing uniform standards governing how hospitals determine which codes to bill. Instead, Medicare relies on hospitals to set their own internal rules.


Graphic by Timothy Meko