top of page

CMS Proposes Physician E/M Coding Changes and More

  • Writer: RYAN FERGUSON
    RYAN FERGUSON
  • Jul 21, 2021
  • 1 min read

Updated: Nov 7, 2024

  1.  

  2. Proposing a definition of split (or shared) E/M visits

  3. Identifying who the appropriate practitioner to bill for the split E/M visit is

  4. Identifying which E/M codes can be reported as split visits

  5. Requires the reporting of a modifier for split visits

  6. Outlining how to document this in the medical record Additional proposals were made to Critical Care Services, including: 

  7.  

  8. Proposing preferred language for the definition of critical care visits and bundled services

  9. Allowing critical care services to be furnished concurrently to the same patient on the same day by more than one practitioner representing more than one specialty, and that critical care services can be furnished as split visits.

  10. Proposing restrictions around what other services can be billed alongside critical care services. Further clarity was proposed around when teaching physicians are present within the primary care exception when determining the appropriate E/M visit level. Under the primary care exception, medical decisions making (MDM) would be used to select the visit level. Other changes to Therapy Services, Physician Assistant Services, Medical Nutrition Therapy (MNT) and Related Services, Provider Enrollment, and the Appropriate Use Criteria have been proposed. MCC’s experts scrub these rules and prepare for changes that would take effect in the coming years (if the proposals are finalized) to ensure compliance from the point of care through claims processing.  Contact our team at info@mccremitone.com to find out how you can utilize RemitOneTM to stay on top of the never-ending changes to coding, coverage, payment, and CMS regulations. To see more about MCC and RemitOne, visit our documentary segment that aired on CNBC here: https://www.mccremitone.net/r1video/MCC_03.mp4.

Comments


Commenting on this post isn't available anymore. Contact the site owner for more info.
MCC™ HORIZ LOGO2.png

MCC provides Health Information Management and computer assisted clinical documentation improvement services that pair with innovative technology with leverage Artificial Intelligence (AI), Machine Learning (ML), and Robotic Process Automation (RPA) to code claims and to analyze and interpret clinical documentation.  Through our proprietary technology and service model, we provide multiple solutions from ambient speech interpretation to complete revenue cycle management. Our goal at MCC is provide a computer free data entry environment to increase patient engagement, improve coding accuracy, reduce provider burnout, and maximize claim revenue and turnaround time.

ADDRESS.png

Address

6500 River Place Blvd Bldg 4
Ste 350, Austin, TX 78730

CAGE
 

93x60

©2025 Med Claims Compliance Corporation. All rights reserved.

bottom of page