RESOURCE: NEW E/M CODES 1/1/2021—>Significant Changes

October 6, 2020

Beginning January 1, 2021 there will be a number of significant changes to the way in which behavioral health and other healthcare providers can and must utilize E/M codes for Medicare services reimbursement.

Many changes make fundamental adjustments to the logic associated with identifying the correct code to bill. In the future these decisions will be based more on the complexity of the decision-making around the care being provided and/or the total time (not just face-to-face time) being spent by the practitioner, to benefit the client.

These changes are likely to have a positive impact on your bottom line. We recommend you assign at least one individual in your agency to become proficient on the changes and help determine what your agency will need to do to be ready for the shift.  We also suggest you get in touch with your EMR vendors to ensure they are making the necessary changes. We know some EMR companies are working on templates, but it is not clear that all EMR vendors are ont heir way to making the necessary adjustments.

Below is a event blurb along with a link to the recording and slides from a recent National Council webinar on this topic.  If your billing, coding and reimbursement staff are part of our NYS Council Billing Geeks  group there’s a decent chance they attended the webinar (we sent the notice to them several times) but we would still encourage all NYS Council members to share this information across the agency.  We hope it helps.  Please let us know!

Are You Ready to Use the New E/M Codes and Services Starting January 1, 2021?

For years, the Centers for Medicare and Medicaid Services (CMS) have heard from physicians and psychiatric clinical staff that the CPT codes for Evaluation & Management (E&M) services were overly burdensome with documentation. CMS has made a number of changes designed to reduce the compliance burden on clinical staff and, in doing so, expand patient care opportunities. The new E&M service codes and requirements will be effective January 1, 2021. In this webinar, David Swann from MTM Services helps psychiatric clinical staff and clinical leaders as well as quality management staff and compliance officers understand the opportunities and obligations created by the new E&M codes.

View the Slides
Watch the Video