2021 E&M Documentation and Coding Changes
E/M office or other outpatient visits (CPT codes 99201-99215). The code set revisions will be effective Jan. 1, 2021.
Summary of revisions
- Eliminate history and physical as elements for code selection
- Allow physicians to choose whether their documentation is based on Medical Decision Making (MDM) or Total Time
- Modifications to the criteria for MDM (New documentation criteria for each level of service)
E&M Readiness Checklist
How Prepared is Your Practice for E/M Office Visit Documentation Changes?
Identify a project lead
Schedule team EDUCATION
Consider CODING SUPPORT
Guard against fraud & abuse law infractions
Update your compliance plan
Check with your electronic health record (EHR) vendor
Assess FINANCIAL IMPACT
Identify a project lead
Schedule team EDUCATION
Consider CODING SUPPORT
Guard against fraud & abuse law infractions
Update your compliance plan
Check with your electronic health record (EHR) vendor
Assess FINANCIAL IMPACT
Attention! Physicians, Nurse Practitioners, Physician Assistants, and Practice Administrators
If your E&M billing bell curve looks like the one below, Call US!
You are probably going to be leaving a lot on money on the table come January 1st, 2021
Bell curve for New and Established patient office visits below. Note: Benchmarks derived from Centers for Medicare & Medicaid Services, E&M Codes by Specialty, calendar year 2010.
| CPT Code | % | |
|---|---|---|
| 99201 | OV,New,Straightforward | 1.28% |
| 99202 | OV,New,Expanded | 15.94% |
| 99203 | OV,New,Low | 45.39% |
| 99204 | OV,New,Moderate | 30.47% |
| 99205 | OV,New,High | 6.91% |
| Totals | 100.00% | |
| 99211 | OV,Est.,Minimal | 3.72% |
| 99212 | OV,Est.,Straightforward | 4.30% |
| 99213 | OV,Est.,Low-Expanded | 48.19% |
| 99214 | OV,Est.,Moderate-Detailed | 40.23% |
| 99215 | OV,Est.,High-Comp. | 3.56% |
| Totals | 100.00% | |
Hub Health System can help ease your Physician’s and Qualified Health Practitioner’s transition into the new documentation and coding changes