Effective January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) is aligning Office and Other Outpatient Evaluation and Management (E/M) coding with changes adopted by the American Medical Association’s Current Procedural Terminology. Also, effective January 1, 2021, the CMS is consolidating and increasing payment for:
- Medicare specific add on code for time intensive services G2211.
- Medicare specific prolonged services code G2212.
- Principal Care Management add-on code for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
This is the most significant change to E/M coding in about twenty-five years.
Clear and concise medical record documentation is critical to providing patients with quality care and is required to receive and retain accurate and timely payment for furnished services. Medical records chronologically report the care a patient received and record pertinent facts, findings, and observations about the patient’s health history. Medical record documentation helps physicians and other health care professionals evaluate and plan the patient’s immediate treatment and monitor the patient’s health care over time.
E/M services are categorized into different settings depending on where the service is furnished. Examples of settings include:
- Office or another outpatient setting
- Hospital inpatient
- Emergency department
- Skilled nursing facility
There is still time for providers to get educated. Beacon Solutions Group Director, Paula Santiago, RHIT, CCS-P, CPMA, CDC, has assisted several organizations with training and education needed to get everyone up to speed. Our approach ensures that everyone on staff is appropriately trained. Reach out today with any questions.
This material has been prepared for general, informational purposes only and is not intended to provide, and should not be relied on for, tax, legal, or accounting advice. Should you require any such advice, please contact us directly. The information contained herein does not create, and your review or use of the information does not constitute an accountant-client relationship.
