tci Medicare Compliance & Reimbursement - 2018 Issue 14

E/M Payment: Will Your Bottom Line Suffer If 99211 and 99215 Pay the Same Amount?

New proposals will hit some specialists hard, CMS statistics suggest. Due to overwhelming feedback, CMS has proposed not only changing the documentation requirements of evaluation and management (E/M) services, but also creating a single relative value unit for both office and outpatient E/M level 2 through 5 codes. These “historic” updates would greatly impact some physicians’ take home pay — and not for the better. Details: CMS plans on updating CPT® codes 99211 through 99215 as well as 99202 through 99205 to reflect what its calling a “blended payment rate,” offering a single relative value unit...

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