Prepare to add new prolonged service codes to your E/M roster

Why This Topic Matters

The article is relevant for readers tracking upcoming Medicare payment changes and payer policy shifts that may affect E/M-related reimbursement workflows and documentation planning.

Article Sections

1. Proposed fee schedule

   Introduces the proposed Medicare fee schedule change and frames the article’s focus on non-face-to-face prolonged service billing. It also places the discussion in the context of CMS policy and payer adoption trends.

2. Add to the well of non-face-to-face services

   Discusses how the proposed change fits alongside other non-face-to-face service categories and broader CMS efforts to recognize work outside the visit. The section also references stakeholder perspectives and possible timing of final rule adoption.

3. Watch out for different billing rules

   Summarizes differences between Medicare’s proposed approach and private payer or CPT-related billing practices. It highlights concerns about date-of-service alignment and related policy interpretation issues.

4. Note 2 additional billing requirements

   Covers proposed overlap limitations with other care management services and CMS’s request for public comment on those intersections. The section also notes additional policy questions raised by the proposal.