University HealthCare Alliance

September 28, 2020

Coding Corner | 2021 Evaluation and Management (E/M) Changes

Effective January 1, 2021, changes made to key elements of the E/M office or other outpatient visits and Prolonged Services. According to American Medical Association (AMA) changes include:

  • Eliminating history and physical exam as elements for code selection
  • Allowing physicians to choose whether their documentation is based on
    Medical Decision Making (MDM) or total time
  • Modifying MDM criteria to move away from simply adding up tasks to focus
    on tasks that affect the management of a patient’s condition
  • Elimination of new patient-level one (99201)
  • Billing based on total time spent
    • Total time includes both face-to-face and non-face-to-face time on the
      date of the encounter
    • No longer requires to be dominated by counseling and/or coordination
      of care
  • New Prolonged services in 15 minutes increments

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