On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee Schedule Final Rule which finalizes payment rates and policies effective January 1, 2021. The changes to 2021 Evaluation and Management (E/M) coding involve only outpatient codes for new patient visits and follow-up visits described by Current Procedural Terminology (CPT) codes 99202-99205 and 99211-99215. 99205, 99211-99215) in 2021. They build on the goals of CMS and providers to reduce administrative burden and put “patients over … https://www.e2emedicalbilling.com/blog/99215-cpt-code-know-your-codes Reimbursement rates shown below are for January 1, 2021, through December 31, 2021. It’s important to note that CPT Code 99213 reimbursement rates vary by location, insurance company, network status, panel, license, and more. and flat reimbursement will be pronounced in 2021 due to the drastic fee schedule cut Physician compensation variables need to be revalued in 2021. On December 27, the Consolidated Appropriations Act, 2021 modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS): CMS has recalculated the MPFS payment rates and conversion factor to reflect these changes. Cognitive Assessment & Care Plan Services (CPT 99483) The AMA has published information regarding these changes. CMS has finalized changes to the way office/outpatient E/M codes (99202-99215) will be chosen and documented. Office/Outpatient E/M Coding (99202-99215) Changes in 2021 Effective with the date of service Jan. 1, 2021, the American Medical Association (AMA), which holds copyright in CPT®, and the Centers for Medicare & Medicaid Services (CMS) implemented major revisions related to office and outpatient E/M codes 99201-99215 in 2021 . However, CMS and the AMA are not in agreement about the use of prolonged care code 99417, resulting in the new HCPCS code. In their 2021 Physician Fee Schedule Final Rule, CMS indicated its agreement with the new E/M definitions for codes 99202—99215 that were developed by the AMA that are in the 2021 CPT ® book. As of January 2021 the appropriate Spravato add-on code 99417 should be reported when physicians are monitoring the Spravato treatment. The new valuations boost total RVUs for nearly all of the office visit codes and elevate RVUs for established office codes 99212-99215 by an average of 28%. reimbursement and code correctly. These modifications to the PFS are the most significant changes made since 1997 and will undoubtedly affect the way in which otolaryngologists practice, from documentation to reimbursement. Coding and Reimbursement Committee. United Healthcare UHC Telehealth Policy POS 02 Modifiers 95/GT/GQ/G0 not required E/M Codes 99201-99215 for commercial plans From 1/1/2021, in-network telehealth services in accordance with current CMS guidelines, the member’s benefit plan and our Telehealth Reimbursement Policy Thru 1/31/2021, waived for in- and out-of-network telehealth COVID- What’s new in evaluation and management coding? CMS Reimbursement •The reimbursement per RVU is being adjusted for 2021 –The budget neutrality adjustment, as required by law, accounts for changes in RVUs including significant increases for E/M visit codes –CY 2021 PFS conversion factor is $32.41, a decrease of $3.68 from the CY 2020 PFS conversion factor of $36.09. relocation expenses taxable vs non taxable, are relocation reimbursements taxed, relocation reimbursement policy sample, new employee relocation reimbursement policy, irs moving expense reimbursement guidelines, relocation expenses paid by employer, employee relocation reimbursement, relocation reimbursement irs Settlement companies had tried everything available free from big … The work relative value units (RVUs) for office-based E/M codes 99202-99215 increased on Jan. 1 as part of the 2021 Medicare Physician Fee Schedule. Global Surgical Packages (Page 242) Table 2: 2021 Requirements for E/M Codes 99212-99215 You may use new prolonged services code +99417 as an add-on code with 99215 for services 55 minutes or longer for payers who follow AMA rules. In this column, I will discuss what implications the 2021 Final Rule on the Medicare Physician Fee Schedule (MPFS) reimbursement may have on your choice of code. Use this interactive reimbursement tool to explore potential clinical and economic benefits of professional CGM for your practice. Prior to January 1, 2021, reimbursement was based on three components: History, Exam and Medical Decision Making. Reimbursement Michael Granovsky MD, CPC, FACEP ... CPT codes 99201 –99215. If you requested these payments, learn how and when we’ll recoup them. These revisions will go into effect on Jan. 1, 2021. • Only one person per minute –if two providers see patient at same time, only one would be counted for each minute. In such cases, additional reimbursement is available for a prolonged service in excess of the time allocated to 99205 (60 to 74 minutes) or 99215 (40 to 54 minutes). An example for a commercial payer would be: the first unit is billable at 55 minutes for 99215, and 75 minutes for 99205. For example, reimbursement for new patient E/M codes 99202-99204 will be reduced. The level of these codes will now be determined using medical decision making or time. Time spent providing prolonged services apply to a given date (eg, single date of service), even when time is not continuous. Office or Other Outpatient (99202-99215) and Prolonged Services (99354, 99355, 99356, 99417) Code and Guideline Changes This document includes the following CPT E/M changes, effective January 1, 2021: • E/M Introductory Guidelines related to Office or Other Outpatient Codes 99202-99215 • Revised Office or Other Outpatient E/M codes 99202-99215 Report these codes when the psychotherapy is for a patient with a life-threatening or highly complex psychiatric crisis. ... –99201 –99215 (Outpatient New and Established) –99341 –99350 (Home Services Codes) ... 2021, CMS finalized HCPCS code G2212 for prolonged ... from $36.09 to $32.26 which in turn will cause a reduction in PFS reimbursement for all professional services by practitioners reimbursed under the PFS. PART 12: AMA Updates: Activate Your Office Visit 2021 Plan December 16, 2020 at 1pm ET The only way your 99201-99215 claims will be accurately paid in 2021 is for you to incorporate ALL the E/M changes correctly before Jan. 1st. A 65-year-old woman with a history of abdominal pain and diarrhea and a ... • How 2021 E/M coding changes will reshape the physician note Total (combined) reimbursement includes operating and administrative components. 2021, history and exam will no longer be used to select an E/M service, but still must be performed to report CPT codes 99202-99215. Then the new 2021 prolonged service add-on code, 99417, can be added to the Level 5. In addition to the highest level of time, the clinicians are permitted to bill a prolonged service code when the time requirement is met. 40 min. Perhaps the biggest news are approved revisions to office and outpatient E/M codes 99201-99215, scheduled for 2021 implementation, covered here. 2021 brought many updates to the Medicare Physician Fee Schedule, notably the increase to the work relative value units (wRVU) of most office based new and established patient evaluation and management services (E/M), including current procedural terminology codes (CPT) 99202-99205 and 99211-99215. CMS also publishes RVUs and payment rates in their online fee schedule look-up tool.. Telehealth. 2021 Reimbursement CMT Services. Visit Complexity CMS has finalized its proposal to implement a Medicare-specific add-on … Refer to the resource section below for guidance on documenting and reporting E/M services accurately. If reporting a new or established patient service (99202—99215) use the new, 2021 E/M guidelines. Example of eCBR Results from eServices The most significant changes are scheduled to take effect on Jan. 1, 2021. 99215 for office or other outpatient evaluation and management services)” to be used when billing Medicare instead of code 99417 (formerly 99XXX) starting in 2021. o E/M services 99202-99205, 99211-99215 have been temporarily added to the Medicare telehealth list and will be reimbursed at parity with in-person visits through the end of the pandemic or December 31, 2021 whichever is later. In less than a month, significant changes are coming to the office and outpatient Evaluation and Management (E&M) services Current Procedural Terminology (CPT®) codes (99202-99215). The section of CPT devoted to remote imaging of retina was thoroughly revised (i.e., 92227, 92228) and appended (i.e., 92229). The revised MPFS conversion factor for CY 2021 is 34.8931. 99215. ... [99202-99205, 99212-99215]): For coding purposes, time for these services is … Reader Mailbag: I read your column in the February 2021 issue of Gastroenterology & Endoscopy News titled “Telehealth Coding and Reimbursement in 2021” (see page 38). As noted above, Medicare provides a different code for prolonged services, and that code has its own rules. On January 1, 2021, big transformations to the office and outpatient evaluation and management (E&M) services (CPT® codes 99202-99215) took place. According to UHC Commercial Plans May Reimbursement Policy Update: Starting 08/01/2021 the new reimbursement policy will apply to E/M (99202-99215) codes. possible billing errors. 7 8 Reimbursement Guidelines ... Kim is an independent coding and reimbursement consultant, providing audit, training and oversight of coding and reimbursement functions for physicians. The new code will be used to report time spent on the date of service for a level five office/outpatient E/M visit (99205 or 99215) that exceeds 15 minutes or more. Additionally, a new code for prolonged visits (G2212, to be used in place of CPT Code 99417, which was referred to as 99XXX in the CY 2021 PFS Proposed Rule) was established to be billed as an add-on to 99205 or 99215 for extra 15-minute increments beyond the standard time for a such visit. The code would be added to E&M codes 99205 and 99215 for every additional 15 minutes required. Described as 99XXX in the 2021 MPFS Proposed Rule, it will be used when the time range for the level 5 office visit indicated in the CPT manual (99205: 60-74 minutes and 99215: 40-54 minutes) is exceeded in 15-minute increments. It’s a really important change—but just to the Evaluation and Management outpatient (office-based) exam codes. Prolonged services in 2021 with 99202–99215: 99417, G2212 The AMA developed CPT® code 99417 for 15 minutes of prolonged care, done on the same day as office/outpatient codes 99205 and 99215… Rates quoted here are example rates that help show generally differing rates across different insurance companies. Office/Outpatient E/M Coding (99202-99215) Changes in 2021 Effective with the date of service Jan. 1, 2021, the American Medical Association (AMA), which holds copyright in CPT®, and the Centers for Medicare & Medicaid Services (CMS) implemented major revisions related to office and outpatient E/M codes 99201-99215 in 2021 . Hear essential information and applicable strategies to strengthen your cancer program’s operations and prepare for these changes. Angie the Coder (Angela Wood, CPC) has over 25 years of experience in physician compliance, education and reimbursement … The Academy has estimated the effect the cuts will have on reimbursements, both to hospital facilities and to physician practices. Medicare 2021 • Medicare has increased the RVUs for E/M codes as part of the E/M changes that go into effect 1/1/2021. CPT codes 99202 through 99215 (new/established E/M) definitions have changed. I haven’t tried to determine how this would all play out in an insurance based practice yet. Click here for a set of AAP resources about these Specialty. $2.4625. There is also a new code, +99417, for prolonged services. Significant Revenue Impact! The American Society of Anesthesiologists (ASA) is reporting that the proposed 2021 national anesthesia conversion factor is set for $19.96, which is down from the current anesthesia CF of $22.20, reflecting a reduction of $2.24. In the CY 2021 proposed rule CMS has also accepted the RUC recommended changes in code descriptors and levels of reimbursement for office-based E/M codes 99202-99215. 2021 Changes to Evaluation and Management Codes and Conversion Factor. Due to the CF reduction, office visit codes will see a diminished payment increase in 2021. 2021 Update: Understanding when to use 99214 CPT Code. OPEN THE TOOL ICD-10-CM Codes. Angie the Coder (Angela Wood, CPC) has over 25 years of experience in physician compliance, education and reimbursement … These revisions will go into effect on Jan. 1, 2021. for 2021. February 9, 2021 February 3, 2021 by Stephanie Cowser. Rural or Self-prep. As of January 1, 2021, there will be significant changes to the office and outpatient Evaluation and Management (E&M) services (CPT ® codes 99202-99215) for both new and established patients. When using the CMS 2021 documentation guidelines for CPT procedure codes 99202–99205 and 99211–99215, providers are required to retain in their records whether they are billing using MDM or time. Access the latest issue of FPM journal. Documentation and coding requirements for outpatient evaluation and management ... (CPT codes 99202-99215… The most common E/M codes reported by chiropractors are 99203 and 99213. Log in to our provider portal. Practices, physicians, and staff must be aware of the modifications to ensure a successful transition next year and avoid any disruption in reimbursement. High. On Nov. 1, 2019, CMS finalized revisions to the evaluation and management (E/M) office visit CPT codes 99201-99215. Repayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021. 99213 Reimbursement Rates – Medicare 2021: $92.47 expanded Medicare reimbursement for telehealth within the annual Physician Fee Schedule (PFS) final rule for 2021. Telemedicine with the same reimbursement? Clinical example 99215 E/M coding. The most common E/M codes reported by chiropractors are 99203 and 99213. Have CPT codes 99354 and 99355 been deleted? CPT 99215, Under Established Patient Office or Other Outpatient Services. The Current Procedural Terminology (CPT) code 99215 as maintained by American Medical Association, is a medical procedural code under the range - Established Patient Office or Other Outpatient Services. E/M Coding and Documentation Education. Codes 99358, 99359 may also be used for prolonged services on a date other than the date of a face-to face encounter. On Nov. 1, 2018, the Centers for Medicare & Medicaid Services (CMS) finalized in the 2019 Physician Fee Schedule final rule significant changes to documentation requirements and reimbursement for evaluation and management (E/M) office visits (CPT® 99201-99215). New prolonged services codes +99417 and +G2212. Reimbursement to a practitioner if a procedure is performed in birth center (25), outpatient hospital-off campus (19), ... 99215 TH: … Shop NOW! 2021 AMA Times for Office Visit Codes Time Time 99211 Not specified 99202 15-29 99212 10-19 99203 30-44 99213 20-29 99204 45-59 99214 30-39 99205 60-74 99215 40-54 8 • Clinical staff time DOES NOT count! For example, consider the new evaluation and management (E/M) coding guidelines that took effect January 1, 2021. EXAMPLE #1 • Office visit for a 16-year-old female, established patient, with long-standing depression and recent intermittent ... ON THE 2021 OFFICE AND OTHER This includes the Evaluation and Management (E/M) changes effective January 1, 2021. I think you will like how time is going to be on your side in 2021. The rates in this post are for non-facilities only. 99215. New prolonged service CPT code for 2021. We understand there are more unique issues to consider in other settings such as emergency department care. Significant changes occurred to chiropractic E/M billing and coding moving into 2021. A: Yes. Learn More: Read 2021 Medicare Physician Fee Schedule and CPT Code Changes Impacting PM&R Practice, featured in … BCBS Minnesota reviewed its Evaluation and Management Services (Commercial, Medicare, Medicaid, Medicare-Medicaid) Reimbursement & Billing Document adding statements including: Beginning in 2021, for codes 99202-99205 and 99211-99215, history and exam will no longer be considered key components. (List separately in addition to CPT codes 99205 and 99215 for office or other outpatient E/M services.) The office visit coding rules you’ve used for the last 20 years will change on Jan. 1 st – and your reimbursement for these essential services is at significant risk.. 4 RVU Impact of 2021 E&Ms ~31% increase in wRVUs (weighted by volume) 2021 99213 is 86% of a 2020 99214 (vs. 64%) 2021 99214 is 90% of a 2020 99215 (vs. 71%) ~12% decrease in Conversion Factor (all codes!) Evaluation and Management (E/M) Codes 99201-99215 (Office and other Outpa-tient) changed effective January 1, 2021. The new valuations boost total RVUs for nearly all of the office visit codes and elevate RVUs for established office codes 99212-99215 by an average of 28%. Other E&M code groupings will be reviewed at a future date. Other E&M code groupings will be reviewed at a future date. Please note that CPT code 99201 has been eliminated effective Jan. 1, 2021. 1/14/2021 7 Visit Complexity Add‐on 2020 2021 % Change G2211 $36.09 $34.89 ‐3.3% G2211 $36.09 $36.09 Nochange 2021 Conversion Factor Change Eliminated if COVID relief bill signed Prolonged service codes G2212 and 99417 • Time based add‐on code to level 5 E&M services (99205, 99215) Coding & Reimbursement Provider Pharmacy Information Preventive health services and coding ... 2021. A key shift for the office and other outpatient E/M codes is that the time referenced in the 2021 code descriptors is total time. Starting CY 2021, CPT codes 99358-99359 (Prolonged E/M without Direct Patient Contact) will not be reportable with office/ TexasPhysician said: Time based coding for evals is requiring increased amounts of time which is a negative on income. Click here to review changes.) Note that the 2021 CPT time requirements give the time for each E/M code as a range (e.g., 30-39 minutes for 99214), rather than as a single number as was the case in prior years. E&M Code 2020 RVUs 2021 RVUs New Patients 99201 0.48 Removed 99202 0.93 0.93 99203 1.42 1.60 99204 2.43 2.60 99205 3.17 3.50 Established Patients 99211 0.18 0.18 99212 0.48 0.70 99213 0.97 1.30 99214 1.50 1.92 99215 2.11 2.80 In addition to moving forward with E/M code changes, CMS reevaluated of the following code sets: MD, PA, RN, LCSW/LMSW. Jan 2, 2021. The 2020 descriptors for these codes use intraservice time. 2021 E/M Coding Changes for MDM. In the next post we will dig deep into how time will be used to determine your level of service. On Nov. 1, 2019, CMS finalized revisions to the evaluation and management (E/M) office visit CPT codes 99201-99215. Your practice can gain thousands of dollars from the 2021 CPT E/M coding changes provided you immediately master the radically new medical decision-making (MDM) based rules. Put the final touches on your E/M coding protocols to ensure you earn the reimbursement you deserve. Get a copy of your 2021 E/M Changes Cheatsheet from innoviHealth by purchasing the Evaluation & Management Comprehensive Guide for 2021 with Cardpack Bundle. 2021 Legend Procedure: CPT/HCPCS code reimbursed by Florida Medicaid in the fee-for-service delivery system. 2021 AMA Times for Office Visit Codes Time Time 99211 Not specified 99202 15-29 99212 10-19 99203 30-44 99213 20-29 99204 45-59 99214 30-39 99205 60-74 99215 40-54 8 • Clinical staff time DOES NOT count! Time spent speaking to a licensed professional on the phone for peer-to-peer review would count. ... 99205, 99215 for office or other outpatient Evaluation and Management services) Clinical Case #1. • Only one person per minute –if two providers see patient at same time, only one would be counted for each minute. January 1, 2021, there will be significant changes to the office and outpatient Evaluation and Management (E/M) services (CPT ® codes 99202- 99215) for both new and established patients. New patient office/outpatient visit services will be reported with CPT codes 99202-99205 ; Established patient office/outpatient visit services will be reported with CPT codes 99211-99215, with 99211 being used to include E/M visits performed by clinical staff for established patients. For the purpose of this CBR, 'peer group' is defined as other providers in Jurisdiction M (JM) who have the same specialty. There are two tables below: one featuring the E/M billing codes providers use for new patients (CPT 99202-99205), and one with codes for established patients (CPT 99211-99215). 2021 E/M Reimbursement Policy Update 2021 E/M Reimbursement Policy Update Effective Jan. 1, 2021, we will be updating our reimbursement policy to follow the revised 2021 ... • The CPT® coding guideline updates only apply to 99202-99215. o Other codes within the evaluation and management section of the CPT book are still Physician Fee Schedule Look-Up Tool. CPT Several facto rs were considered when providing the 2021 recommendations, including: CPT 99201 will be deleted. Deliver estimates of patient copayments, coinsurance and deductibles. Reimbursement rates for 99202–99215 will be updated retroactive to DOS on or after January 1, 2021. After entering basic patient and claims information, the cost estimator uses your fee schedule and your patients' benefits plans to: Show you our estimated payment to you. Described as 99XXX in the 2021 MPFS Proposed Rule, it will be used when the time range for the level 5 office visit indicated in the CPT manual (99205: 60-74 minutes and 99215: 40-54 minutes) is exceeded in 15-minute increments. Effective 01/01/2021: Claims filed for professional outpatient prolonged services (both 99417 and G2212) will be considered for reimbursement as described by Centers for Medicare & Medicaid Services’ (CMS) Prolonged Office ... service, except office or other outpatient services (99202-99205 and 99212-99215). Criteria for Code Selection . Due to the CF reduction, office visit codes will see a diminished payment increase in 2021. The first wave of updates includes the modification of ten E&M codes representing standard, established and new patient visits (codes 99201-99215). They build on the goals of CMS and providers to reduce administrative burden and put “patients over paperwork” thereby improving the health system. 99215 10 45 15 70 70 Office/Outpatient E/M Services Code Set, and the New Prolonged Services Code HCPCS Code Current Total Time Current Work RVU CY 2021 Total Time CY 2021 Work RVU RUC-rec Total Time RUC-rec Work RVU 99201 17 0.48 17 0.48 N/A N/A 99202 22 0.93 22 1.76 22 0.93 99203 29 1.42 29 1.76 40 1.6 New in 2021: • Code 99201 (level 1 new office/outpatient visit) has been deleted, and codes 99202-99205 and 99211-99215 have been modified. $2.4150. CMS issued information on COVID-19 Accelerated and Advance Payments. Your Academy submitted comments to the proposed rule in early October.. Patient cost estimator is available on our provider portal on Availity. BCBSND encourages provider offices to stay informed of these changes. HOW TO USE THIS WEBINAR ... 99202-99205 and established patients 99211-99215. Managing your specialty practice’s reimbursement is an intricate process and proper coding makes all the difference. March 1, 2021. Your failure to accurately adopt the new Evaluation and Management (E/M) office visit coding rules for 99201-99215 by the deadline will cause your payments for these services to come to a grinding halt. I'd like to submit a/an Idea/Suggestion Problem Comment. eliminate GPRO1 previously finalized for CY 2021. 6/15/2021 Leadership Discusses Lessons Learned from Latest MHS GENESIS Waves; 6/14/2021 Armed Services Blood Program Donors Keep the World Beating; 6/11/2021 Hernias: What Every Service Member Should Know Reimbursable CPT Code: CPT Code Description With less than 60 days until 2021, ... 99215. The new code will be used to report time spent on the date of service for a level five office/outpatient E/M visit (99205 or 99215) that exceeds 15 minutes or more. Time spent providing prolonged services apply to a given date (eg, single date of service), even when time is not continuous. Beginning in 2021, there will be a new code for reporting prolonged services together with an office visit. Using the same example from above, a 99213 code, in 2021, would result in a Medicare reimbursement … 2021 Unified CMS AND CPT Documentation Guidelines “2021, for office/outpatient E/M visits (CPT codes 99201-99215), we proposed generally to adopt the new coding, prefatory language, and interpretive guidance framework that has been issued by the AMA/CPT because we believed it would accomplish greater burden reduction.” In 2021, E/M code selection will be based on either: 1) The level of medical decision making (MDM) OR 2) The time performing the service on the day of the encounter. The analysis shows the portions of your Established Patient Office Visit family of codes (CPT codes 99211-99215) claims at each level compared to your peers in JM. I think you will like how time is going to be on your side in 2021. CPT 2021 assigns 60-74 minutes to 99205 for a new patient office visit and 40-54 minutes to 99215 for an established patient level five visit. See below for an example of how to calculate the debt millage rate: • 2021 Debt service (adjusted for reserve and uncollectible taxes): $200,000 • 2021 School debt loss reimbursement: $2,000 • 2021 Desired debt tax levy: $200,000 minus $2,000, or $198,000 Allowed Charges. But the new changes make it so much easier to qualify for complexity based on MDM. Code 99211 does not have a time component in 2021 and is appropriate In a nutshell, these new guidelines state that the history and physical exam will not determine the appropriate E/M code level for E/M codes 99202 through 99215. Quick Guide to 2021 Spravato treatment should be reported in conjunction with companion Evaluation & Management (E/M) codes such as 99205 or 99215. AMA has revised the definitions for E/M codes 99202–99215 in the Current Procedural Terminology (CPT) 2021 codebook. Check out our guide to Psychiatric CPT codes here! The existing guidelines were developed in 1995 and 1997 and remain in effect for all other E/M services determined by history, exam, and medical decision-making (MDM). This policy applies to services that are performed in POS 19 (Off Campus Outpatient Hospital) or POS 22 (On… Online CEU, e/m courses, web based e&m compliance solutions The changes havebeen finalized by … CY 2021 Physician Fee Schedule Update. Starting CY 2021, CPT codes 99358-99359 (Prolonged E/M without Direct Patient Contact) will not be reportable with office/ Comparing E/M Reimbursement Rates. 2021 school debt loss reimbursement that will be received. During the Public Health Emergency (PHE), CMS lifted and added several regulations related to telehealth on a temporary basis. In FY 2021, revenue relies on less dependable sources of revenue, such as Marijuana sales, ... Increase in Circuit Breaker Reimbursement over original projection. Do … reimbursement 02 HOPPS and MPFS final rule key points Telehealth services 03 Office and outpatient E/M 04 05 ... CY 2021 conversion factor is $32.41 decrease of $3.68 from CY2020 ... 99211 -99215 Office/outpatient visit est pt. On January 1, 2021, E/M coding updates took effect and level determination is now based on either time or medical decision making. They build on the goals of CMS and providers to reduce administrative burden and put “patients over paperwork” thereby improving the health system. ConnectiCare is following CMS minimum time guidelines and allowing G2212 to be used with 99205 or 99215. #5. Reimbursement Policy: Consultation Services Payment Effective Date: November 16, 2015 Last Revised Date: March 8, 2021 Purpose: Provide guidelines for the reimbursement of CPT consultation codes (99241-99245 or 99251-99255) for Commercial and Medicare Advantage products. Reader Mailbag: I read your column in the February 2021 issue of Gastroenterology & Endoscopy News titled “Telehealth Coding and Reimbursement in 2021” (see page 38). Because 99215 is the longest E/M code for established patients (40 minutes), modifier -21 will allow you to bill for extra time.
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