E/M Coding

Evaluation and Management (E/M) Coding Resources

As noted on the American Medical Association webpage for “Implementing CPT® Evaluation and Management (E/M) revisions”:

“Together, the AMA and Centers for Medicare & Medicaid Services (CMS) have achieved the first overhaul of evaluation and management (E/M) office visit documentation and coding in almost 30 years. These landmark E/M office visit code changes deploy Jan. 1, 2021.”

Below are updates and resources to help understand and implement landmark E/M office visit code changes to meet the January 1, 2021 deadline.

Listen to the top questions asked during the AMA webinar on E/M 2021 revisions

On Tuesday, August 11, the AMA and featured guest panelists provided participants with a high-level overview of the landmark changes to E/M office visit coding, which are approved by the CPT Editorial Panel and scheduled to be implemented by CMS, take effect January 1, 2021. During this webinar, the presenters provided baseline education on the revisions, introduced AMA E/M resources, and fielded questions directly from participants. Download the webinar recording to hear AMA experts answer questions regarding the new codes. Download the presentation slides. Please refer to this 10-step checklist to prepare your practice for E/M office visit changes.

Learn more about AMA’s ongoing work on E/M revisions.

Links to additional AMA E/M coding information

Note:

  • CMS posted proposed 2021 fee schedule rules on August 4 for public comment (comments are due to CMS by October 5, 2020). As part of its proposed (but not yet final) fee schedule rules, CMS has proposed to change the time requirements for billing prolonged care code 99XXX in 2021.

    • In the first AMA document above in this box, AMA instructions are to bill prolonged care after the minimum time is exceed by 15 minutes.

    • In contrast, CMS is proposing to bill prolonged care after the maximum time is exceeded by 15 minutes. The relevant section of CMS’s proposed rules is attached.
Updated Wednesday, 16-Sep-2020 09:03:15 CDT