Evaluation and Management (E/M) Office Visits 2021
Evaluation and Management (E/M)
Office Visits¡ª2021
Peter Hollmann, MD
Christopher Jagmin, MD
Barbara Levy, MD
Agenda
? History of E/M Workgroup
? E/M Revisions for 2021: Office and Other Outpatient Services
o New Patient (99201-99205)
o Established Patient (99211-99215)
o Medical Decision Making (MDM)
o Time
o Prolonged Services
? AMA CPT? E/M Education
2
? 2020 American Medical Association. All rights reserved.
How Did We Get Here?
Medicare E/M Initial 2019 Fee Schedule Proposal (Released July 2018): SUMMARY
The goal was administrative simplification and CMS perceived current E/M codes as ¡°outdated¡± based on past
comment letters
?
Medical Necessity:
o Eliminate the requirement to document medical necessity of furnishing visits in the home rather than
office
o Eliminates the prohibition of same-day E/M visits billing by physicians in the same group or medical
specialty
o Documentation of level 2 necessity for Office E/M is sufficient
?
Documentation redundancy:
o Eliminates the need to re-enter information regarding chief complaint and history that is
already recorded by ancillary staff or the beneficiary. The practitioner must only document
that they reviewed and verified the information.
3
? 2020 American Medical Association. All rights reserved.
How Did We Get Here?
Medicare E/M Initial 2019 Fee Schedule Proposal (Released July 2018):
SUMMARY
1. Simplify code level selection and remove unnecessary history and
examination elements
? Physicians may choose method of documentation
o CMS 1995/1997 Documentation Guidelines (ie, current standards)
o MDM only, or
o Face-to-Face time
? Simplification included elimination of payment differentials between
services
4
? 2020 American Medical Association. All rights reserved.
Medicare E/M Initial 2019 Proposal (Released
July 2018): Summary
2. Condensing Visit-Payment Amounts
CMS calls the system of 10 visits for new and established office visits
¡°outdated¡± and proposes to retain the codes but simplify the payment by
applying a single-payment rate for level 2 through 5 office visits.
5
CPT? Code
New Office
Visits
CY 2018
Non-Facility
Payment Rate
CY 2019 Proposed
Non-Facility
Payment Rate
CPT Code
New Office
Visits
CY 2018
Non-Facility
Payment Rate
CY 2019 Proposed
Non-Facility
Payment Rate
99201
99202
99203
99204
99205
$45
$76
$110
$167
$211
$43
$134
99211
99212
99213
99214
99215
$22
$45
$74
$109
$148
$24
$92
? 2020 American Medical Association. All rights reserved.
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related download
- evaluation management e m eval
- tip sheet outpatient evaluation management services pt
- documentation for e m office visits in 2021
- evaluation and management services guide booklet
- evaluation and management e m office visits 2021
- evaluation management e m coding in 2021
- time based billing for e m in 2021 and beyond
Related searches
- cms e m guideline changes 2021 final rule
- new evaluation and management guidelines 2021
- physician evaluation and management coding article
- 1995 evaluation and management worksheet
- evaluation and management guidelines
- evaluation and management audit worksheet
- evaluation and management coding practice
- evaluation and management coding cms
- evaluation and management coding quiz
- cms evaluation and management 2021
- evaluation and management services guide
- evaluation and management coding examples