decisionhealth Newsletters, Part B News - 2011 Issue 1 (January)
Ratio of E/M to procedures billed, by specialty
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Article Overview
This article reviews a specialty-by-specialty comparison of evaluation and management billing against procedure billing, based on 2009 Medicare data. It is intended for coding, billing, and practice management audiences who want a broad benchmark for specialty-level service mix and a general sense of how the analysis is framed.
Why This Topic Matters
Understanding the relative balance between evaluation and management services and procedures can help practices benchmark their billing patterns against peers and identify areas for further review. The article provides context for comparing specialty-level utilization patterns without serving as a coding guide.
What You Will Learn
- How the article compares specialties using a ratio-based view of service mix
- What broad patterns appear among primary care, procedural, and surgical specialties
- How the analysis frames Medicare-billing trends across specialties
- Why benchmark comparisons can be useful for billing review
Who Should Read This
- Coders
- Billers
- Practice managers
- Revenue cycle staff
- Physician groups
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