CMS changes to E/M Office/Outpatient Codes (99201-99205, and 99211-99215) will be in effect starting January 1, 2021.
- Providers may select new and established patient visit level of service based on time or medical decision making (MDM)
- Code 99201 will be deleted
- New time guidelines 99202—99215. Time will be defined as total time spent, including non-face-to-face work done on that day, and will no longer require time to be dominated by counseling.
- Visits will have a range for time, e.g., 99213 will be 20-29 minutes, 99214 will be 30-39 minutes
- Revised MDM guidelines
- There will be no required level of history or exam for visits 99202—99215.
- All other E/M services that are defined by the three key components will continue to use the 1995 and/or 1997 Documentation Guidelines.
- To date, only Medicare is committed to the E/M changes.
- Only Office/Outpatient E/M codes are impacted by the changes.
What to do to prepare?
- Provider Education and Training
- Revise Policies and Procedures
- EHR and template updates
- Assess financial impact