DecisionHealth, DecisionHealth - 2012 Issue 4 (April)

Benchmark of the Week: Ratio of paid level 3 to level 4 E/M visits, 2010

This chart presents the ratio of paid level 3 E/M visits to paid level 4 E/M visits – both for initial and established patients – at 10 Medicare-heavy specialties. Based on a Part B News analysis of 2010 Medicare claims, the data points for initial visits were determined by taking the total number of paid visits billed as 99203 for each specialty – subtracting all denied visits – and dividing this figure by the total paid 99204 visits. This process was repeated for established patient visits using codes 99213 and 99214.

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