2021 marked the first change in 20 years in how we billed for OUTPATIENT visits
7 major changes in the new OUTPATIENT BILLING guidelines follow.
A #tweetorial that literally makes you money 💵
#medtwitter #neurotwitter
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1. History & Exam does not count towards billing.
Only medical decision making (MDM) or time counts.
That does not mean no history or exam; medically appropriate history and exam is still needed,
But you don't have to obsess about 4 "qualifiers" for the chief complaint.
2. Billing by time is expanded.
Includes all activities for patient care.
Activities need to be done from midnight to midnight on the date of service.
Pro tip: Complete your note on date of service to add that time to the total time.
Can lead to a higher level of billing.
3. Time cut-offs are slightly different
Mostly affects level 3 and level 4 established visits.
Level 3 (99213) now starts at 20 min instead of 15
Level 4 (99214) now starts at 30 min instead of 25
For additional time beyond Level 5, use 99417/G2212 in 15 min increments.
4. Resident time
Time taken for discussion with resident/trainee can now be included in total visit time.
Can be helpful in academic settings.
5. No more Level 1 New Visits
6. MDM rules changed (a lot)
3 elements for MDM:
• Number & complexity of problems addressed
• Amount/complexity of data analyzed
• Risk of complications &/or morbidity/mortality of management
4 Levels:
• Straightforward
• Low
• Moderate
• High
🔥more explanation soon
7. MDM vs. Time
Bill for whichever is greater: MDM OR Time
This is the first in a series of tweets and tweetorials on this topic.
Also, watch out for @Neurobolts episode on this topic coming soon ft. yours truly.
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