tci Medicare Compliance & Reimbursement - 2021 Issue Q1

Industry Notes: Pocket New Medicare Advice on E/M Claims Review

If you were wondering whether the Centers for Medicare & Medicaid Services (CMS) would be reviewing office/ outpatient E/M service claims as practices transition from the old to new guidelines, the answer is yes. However, in a new fact sheet CMS does offer a tip on what reviewers will be looking for when time is used to determine the visit level. Details: On Jan. 11, CMS released a short fact sheet on the 2021 E/M guidelines finalized in the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) final rule. The brief review looks at the “the new...

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