Tag: AMA

2023 Medicare Physician Fee Schedule on Unsustainable Cuts

2023 Medicare Physician Fee Schedule on Unsustainable Cuts

Lower Medicare payments to physicians will lead to patient care by reducing access to services, according to medical groups commenting on the 2023 Medicare Physician Fee Schedule (PFS). In July, the U.S. Centers for Medicare & Medicaid Services (CMS) announced the 2023 proposed rule and physician groups have been responding, including with detailed comments published […]
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Prolonged Services in CPT versus Medicare

Prolonged Services in CPT versus Medicare

The code 99417 is invalid for Medicare and MA reimbursement. When the CPT® Guidelines were updated for 2021, one of the options for leveling an office or other outpatient evaluation and management (E&M) service was to use time as the leveling agent. The time thresholds for each E&M office visit were also changed from “typical” […]
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AMA on Evaluation and Management Service Codes Guidelines

AMA on Evaluation and Management Service Codes Guidelines

Medical coders who were unsure what documentation non-Medicare payers would expect in light of the Patients Over Paperwork Initiative now have more to go on. The initiative reduced documentation requirements for outpatient evaluation and management service codes (CPT® 99201-99215) provided to Medicare Part B patients beginning in 2021. The Centers for Medicare & Medicaid Services (CMS) indicated in their initiative that, although […]
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CPT update

CPT 2020 and CPT 2021: Catch a Glimpse

Preview of CPT® Code Changes for 2020 and 2021 The CPT® Editorial Panel’s February 2019 meeting introduced several key updates set to take effect in CPT 2020 and 2021, including significant revisions, deletions, and additions across multiple specialties. Major Changes for CPT 2021 The most notable update is the revision of office and outpatient E/M […]
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Mid-Year CPT Code Updates

Prepare Now for These Mid-Year CPT Code Updates

In addition to the annual release of CPT® code changes, the American Medical Association (AMA) likes to keep medical coders on their toes by releasing mid-year changes. The following Vaccine codes and Category III codes were accepted and/or revised at the September 2018 CPT Editorial Panel meeting for the 2020 CPT® production cycle. These codes are effective July […]
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