General Internal Medicine (GIM) New Fees Codes



MSP has recently announced new GIM (General Internal Medicine) Fee codes for General Internists. The new GIM codes only apply to General Internists who have completed 3 years of core Internal Medicine training, plus at least 1 full year of General Internal Medicine training.


There are 3 distinct categories for GIMs (General Internal Medicine Specialists). The new codes are only applicable to Category 2.

Category 1 Category 2 Category 3
GIMs who have less than 4 years of GIM training. GIMs with 4 years or more of GIM training. GIMs only (i.e., no sub-specialty) For Complex Patients.


It’s crucial to make sure you know exactly what you can and cannot bill. Billing properly, and accurately, is extremely important in order to avoid penalties while at the same time maximizing earnings. In order to make things easier, we’ve outlined each GIM category and the relevant billing codes and fees that go along with them.

The following codes are effective as of October 1, 2018.

Category 1

GIMs who have less than 4 years of GIM training can bill the following fee codes:

Code Explanation Fee
00312 Repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant the consultative services do not warrant a full consultative fee $80.37
00310 To consist of examination, review of history, laboratory, X-ray findings, and any additional visits necessary to render a written report. $166.35


Continuing care by consultant:

00308 Subsequent Hospital Visit $28.71


Telehealth Service with Direct Interactive Video Link with the Patient:

32270 Telehealth Consultation: To consist of examination, review of history, laboratory, X-ray findings, and additional visits necessary to render a written report. $166.35
32272 Telehealth repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant, the consultative services do not warrant a full consultative fee. $80.37
32276 Telehealth Directive Care $71.32
32277 Telehealth Subsequent Office Visit $49.71
32278 Telehealth Subsequent Hospital Visit $28.71

 

Category 2

GIMs with 4 years or more of GIM training can bill the following NEW fee codes:

Code Explanation Fee
32210To consist of examination, review of history, laboratory, X-ray findings, and any additional visits necessary to render a written report.$202.57
32212Repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant the consultative services do not warrant a full consultative fee$90.00



Continuing Care by consultant:


Telehealth Service with Direct Interactive Video Link with the Patient:

32206 Directive Care $85.00
32208 Subsequent Hospital Visit $50.00
32370 Telehealth Consultation: To consist of examination, review of history, laboratory, X-ray findings, and additional visits necessary to render a written report. $202.57
32372 Telehealth repeat or limited consultation: Where a consultation for same illness is repeated within six months of the last visit by the consultant, or where in the judgment of the consultant, the consultative services do not warrant a full consultative fee. $90.00
32376 Telehealth Directive Care $85.00
32378 Telehealth subsequent hospital visit $50.00


Category 3


GIMs ONLY (i.e., no sub-specialty) For Complex Patients can bill the following fee codes (see below for a list of chronic diseases).

Code Explanation Fee
00311 Complex Consultation - Payable for patients that have 3 or more chronic diseases. For hospital in-patients, paid once per patient per hospital admission. $263.52
32271Telehealth Complex Consultation - Payable for patients that have 3 or more chronic diseases. Limited to one per patient in a 6-month period.$263.52
32307Subsequent follow-up office visit, complex patient – 3 medical conditions. Payable only if 00311 is paid within the previous 6 months.$90.00
32308Subsequent Hospital Visit, Complex Patient – 3 Medical Conditions. $53.00

32308 is payable only to admitted patients and only if it’s paid within the previous 6 months. 32308 is also payable for ongoing inpatient follow up care, for each day hospitalized during the first ten days of hospitalization, (thereafter, you’ll bill 00308).

The total of all daily billing under this fee item that are accepted for payment by MSP will be calculated for each practitioner for each calendar day. Daily totals will be paid as follows:

1-15 visits paid at 100%
16 or more visits paid at 50%.

Note: Fee Codes 00311, 32271, 32307, and 32308 (Category 3) are payable with a written consultation report that includes advice or recommendations for treatment, regarding 3 or more of the following conditions:

Disease Diagnostic Code
Coronary Atherosclerosis 414
Septicemia038
Other HIV Infection044
DM including complications250
Disorders of Lipid Metabolism272
Thyroid disorders246
Purpura, Thrombocytopenia and Hemorrhagic conditions 287
Anemia, unspecified285.9
Senile Dementia, Presenile Dementia290
Acute Confusional State293
Congestive Heart Failure428
Diseases of the Aortic and Mitral valve396
Essential Hypertension401
Neoplasm of uncertain behaviour of other and unspecified sites. "Not for minor or superficial skin malignancies."238
Cardiac Dysarrhythmias
Cerebral Atherosclerosis437
Asthma Allergic Bronchitis 493
Emphysema 492
Other Bacterial Pneumonia 482
Non Infective Enteritis and Colitis 557.1
GI Hemorrhage 578
Chronic Liver diseases and Cirrhosis of the Liver571
CRF585
ARF 584
Systemic Lupus Erythematosus 710
Disorders of fluid, electrolyte and acid base balance 276
Syncope 780.2
cell1_3 cell2_3
Venous thrombosis and embolism 453
Pulmonary fibrosis 515
Rheumatoid Arthritis 714


Exceptions to this rule can be made if the patient has two diagnoses from this list and one alternative diagnosis not on this list. If that is the case, it has to be submitted with correspondence/note records, outlining the medical necessity. Each case will be reviewed on an independent consideration basis.

If you have any questions regarding GIM codes, please don’t hesitate to contact our team here.