Code changes coming for evaluation and management visits: 4 things to know

Morgan Haefner for Becker’s Hospital Review

In its proposed Physician Fee Schedule for 2021, CMS outlined changes to how office and outpatient evaluation and management visits will be coded.

Four things to know:

1. CMS proposed a refinement to clarify the times when prolonged office and outpatient E/M visits can be reported. The department proposed revaluing eight code sets, including maternity services, therapy evaluation and transitional care services.

2. Under the rule, history and physician exam won’t be used to determine a visit’s code level. Physicians can also choose if their documentation is based on medical decision-making or total time.

3. CMS is increasing payment bundles for maternity care and other services, but not the surgical global payment bundle. The American Medical Association urged CMS to add payment increases into the global surgery packages.

4. The changes would take effect at the start of 2021.