decisionhealth Newsletters, Part B News - 2011 Issue 9 (September)
Benchmark of the Week: Medicare vs. private E/M utilization by level, 2010 (powered by RelayHealth)
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Article Overview
This article reviews aggregate evaluation and management utilization patterns using claims data from RelayHealth across Medicare and private payer populations. It is relevant to coders, billing teams, and practice analysts who want a high-level view of how E/M level distribution is being measured and compared across payer types, including discussion of the data source and fee schedule context.
Why This Topic Matters
Payer-mix comparisons can highlight differences in overall E/M level distribution and help readers understand benchmark-style utilization reporting without relying on CMS claim data.
What You Will Learn
- How E/M utilization is compared between Medicare and private payer claims data
- What the article’s benchmark charts are based on
- How the article frames new patient versus established patient utilization patterns
- What general trends are noted in the payer comparison
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle analysts
- Practice managers
- Healthcare data analysts
Codes Discussed
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