{"id":9985,"date":"2019-10-31T13:34:31","date_gmt":"2019-10-31T08:04:31","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=9985"},"modified":"2020-12-21T14:04:40","modified_gmt":"2020-12-21T08:34:40","slug":"ama-announces-2021-em-changes","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/ama-announces-2021-em-changes\/","title":{"rendered":"AMA Announces 2021 E\/M Changes"},"content":{"rendered":"

In 2018, Medicare announced its plans for revamping the Evaluation and Management coding structure and was met with a rapid response from the medical community, including the AMA and many other organizations. As a result, the Medicare changes implemented in 2019 were mostly documentation-related changes that generally benefited providers but were not necessarily accepted and implemented by all payers.<\/p>\n

In March, the AMA posted the CPT Editorial Summary of Panel Actions for February 2019, which lists specific changes that they intend to make to the E\/M codes, effective January 1, 2021. Although the AMA plans to make significant changes to E\/M, they in no way are as extreme as the original proposed Medicare E\/M changes. Additionally, as the CPT Editorial Committee met earlier this month and will also meet in September, we may see even more E\/M changes following the summary from those meetings (May 9-11 and September 26-28).<\/p>\n

Medicare has published the 2021 E\/M changes they intend to make and now, so has the AMA. We’ve all seen that when Medicare and CPT do not agree on the way in which a specific service, or group of services, should be reported, Medicare may produce HCPCS code(s) with specific guidance for Medicare contracted providers to follow. As any coder is well aware, when a provider is contracted with a payer, they must follow the guidelines and policies specific to the contract they have signed, whether or not it matches with the CPT guidelines.<\/p>\n

As coders know, when a provider contracts with a payer, they must follow the guidelines and policies specific to the contract they have signed, whether or not it matches the CPT guidelines. Now that the AMA has published these changes, we will need to wait and see how Medicare responds to them.<\/p>\n

E\/M codes affected<\/h2>\n

The new AMA CPT E\/M changes are specific only to Office or Other Outpatient Services (99201-99205 and 99211-99215) codes. To date, we don\u2019t have any changes to the inpatient or observation codes. Unless the AMA makes further modifications, these changes will be included in the 2021 CPT codebook, so payers, including Medicare, will need to decide whether or not they will adopt them. They include:<\/p>\n