The AMA is significantly revising the documentation guidelines for the oft-used 99202–99215 code set, and all payers—public and private—are expected to adopt the changes.

With the release of the proposed 2021 Medicare physician fee schedule on August 4, CMS confirmed the new direction, which marks the first significant revision to the E/M code set from Medicare in more than 20 years.

Because E/M services are at the heart of many practices’ revenue, these changes could significantly disrupt your current E/M payment policies and documentation guidelines. Practices need to understand CMS’ proposals to map out a clear strategy ahead of the January 1 start date.

Don’t miss this chance to prepare your organization early for the upcoming big E/M code set changes!

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The E/M change affects only nine codes. Why do I need a full range of training?

Revenue. True, the 2021 changes affect only nine codes, but they’re codes that have outsize importance. The E/M office visit codes are reported millions of times per year, and tied to billions in payments. Disruption to E/M coding and billing could significantly derail your revenue cycle – far more than a change to other types of codes.
Documentation. The new documentation rules are complex. Sure, the “history” and “exam” elements no longer factor into coding. But the new medical decision-making (MDM) guidelines contain multiple/layered decision trees that you’ll have to master.
Other factors. Besides the new documentation guidelines, there are a host of other changes: a primary care add-on code; a new prolonged services code; new time standards and rules, to name a few. You’ll have to know the entire range of 2021 updates to find success next year.

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