CMS Pub. 100-04, ch. 12, § 30.6.12.3

Specialties

(Rev. 11288; Issued: 03-04-22; Effective: 01-01-22; Implementation: 02-15-22)

Concurrent care is when more than one physician renders services that are more extensive than

consultative services during a period of time. The reasonable and necessary services of each

physician furnishing concurrent care is covered when each plays an active role in the patient’s

treatment. In the context of critical care services, a critically ill patient may have more than one

medical condition requiring diverse, specialized medical services and requiring more than one

practitioner, each having a different specialty, playing an active role in the patient’s treatment.

Medicare policy allows critical care visits furnished as concurrent care (or concurrently) to the

same patient on the same date by more than one practitioner in more than one specialty (for

example, an internist and a surgeon, allergist and a cardiologist, neurosurgeon and NPP),

regardless of group affiliation, if the service meets the definition of critical care and is not

duplicative of other services. Additionally, these critical care visits need to be medically

reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the

functioning of a malformed body member.