Understanding E/M: Office visits: No CMS shift on split/ shared billing, prolonged visit code

Why This Topic Matters

These CMS clarifications affect how practices document and report common E/M services, especially when multiple clinicians are involved or when visits extend beyond typical time expectations. Understanding the current guidance helps support compliance and reduce billing errors as 2024 rules are applied.

Article Sections

1. CMS update on split/shared billing for E/M office visits

   Summarizes the CMS position on split/shared billing for E/M office visits and describes the scope of the policy update for 2024. It also places the guidance in the context of facility and outpatient settings.

2. Documentation and compliance review for split/shared visits

   Reviews broad documentation expectations and practice-level checks related to split/shared E/M reporting. The section also addresses general considerations for payer policy review and internal billing references.

3. No change for prolonged service code G2212

   Explains that CMS is not revising its prolonged service guidance to mirror the updated office/other outpatient E/M descriptors. The section discusses the broader impact on time-based reporting and related Medicare policy materials.