My palliative care program has been billing inpatient consultation codes that are time-based. This has worked well for us. However, our hospital has now decided that consultants can no longer bill inpatient consultation codes if the consulted physician manages any portion of the patient's care (as an example - if we recommend changing morphine to fentanyl, it's a consult, but if we manage the PCA, we have to bill as a routine daily inpatient visit and not a consult). Since we bill based on time spent with the patient, I think our reimbursement will still be good. I suspect that other specialties that do not bill on time spent will face a cut in reimbursement. I was wondering, how have other palliative care programs been billing inpatient consults? Has anyone else encountered this change in coding?