E/M Coding Changes are Coming. Effective 1/1/2021

CPT E/M Office Revisions, Level of Medical Decision Making (MDM) Table 10/13/2020

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Medical Necessity 2021 Coding Quick Reference Sheet

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2021 Evaluation and Management Code Revisions Helpful Links and Other Resources 10/12/2020

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CPT® Evaluation and Management (E/M) Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99XXX) Code and Guideline Changes

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AAP New Repayment Terms 10/12/2020

CMS released further information about the Medicare Accelerated and Advance Payment (AAP) program following the Continuing Resolution passage that revised the program’s repayment terms. Most notably, it appears CMS is automatically delaying recoupment for one year and will issue guidance on the recoupment process at a later date. The legislative text stated that CMS could delay payments “upon request” of the provider, and with this announcement, CMS will instead go further by automatically applying the delay to all recipients. From the announcement linked above:

Providers were required to make payments starting in August of this year, but with this action, repayment will be delayed until one year after payment was issued. After that first year, Medicare will automatically recoup 25 percent of Medicare payments otherwise owed to the provider or supplier for eleven months. At the end of the eleven-month period, recoupment will increase to 50 percent for another six months. If the provider or supplier is unable to repay the total amount of the AAP during this time-period (a total of 29 months), CMS will issue letters requiring repayment of any outstanding balance, subject to an interest rate of four percent.

Drew Voytal
Associate Director
MGMA Government Affairs
Washington, DC

Public Health Emergency Extension

HHS has extended the PHE for another 90 days as indicated in the announcement on this link and below. https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-23June2020.aspx

Renewal of Determination That A Public Health Emergency Exists

As a result of the continued consequences of Coronavirus Disease 2019 (COVID-19) pandemic, on this date and after consultation with public health officials as necessary, I, Alex M. Azar II, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective July 25, 2020, my January 31, 2020, determination that I previously renewed on April 21, 2020, that a public health emergency exists and has existed since January 27, 2020, nationwide.


/s/_____________________________Alex M. Azar II

Supervising Physician Should Bill Incident-to Services, CMS Clarifies, Part B News, 11/09/2015

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89 Telehealth Services with a Telephone Call

Providers can now perform 89 telehealth services with a telephone call, CMS says

A phone call with a patient — plus complete documentation — will be all it takes to report 89 services on Medicare’s telehealth list. Practices will also be able to receive full reimbursement for 39 new services performed via telehealth according to the updated telehealth list posted today. The changes are retroactive to March 1. For the full article and list, visit the POET Ink File, CoVID-19.

Providers can now perform 89 telehealth services with a telephone call 05012020

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