decisionhealth Newsletters, Part B News - 2011 Issue 10 (October)
CMS data: E/M revenue still up with consults gone, part of bigger trend
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Article Overview
This article reviews CMS claims data showing how evaluation and management revenue and utilization changed in 2010, the first year after consult codes were eliminated. It focuses on trends across high-volume Medicare specialties, shifts in beneficiary enrollment, and the broader factors that may have influenced year-over-year payment patterns. The content is aimed at coders, billing professionals, and specialty practices that track Medicare E/M utilization and revenue trends.
Why This Topic Matters
Understanding broad E/M utilization and revenue trends helps practices interpret Medicare payment patterns, compare specialty-level changes, and place code-set changes in a larger claims-data context.
Article Sections
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Revenue increase
Discusses year-over-year E/M revenue and utilization trends among the highest-volume Medicare specialties, including specialty-level outliers and general claims-data patterns.
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Bigger trend at work
Explores broader factors affecting E/M volume, including enrollment shifts and changes in how Medicare beneficiary populations are reflected in CMS data.
What You Will Learn
- How CMS claims data can be used to compare E/M revenue trends across specialties
- What broad factors may influence Medicare E/M utilization over time
- Why changes in beneficiary enrollment can affect apparent utilization patterns
- How specialty-level trends can differ within the same reporting year
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Revenue cycle professionals
- Physician specialty practices
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