AMA supports CMS proposed rule to reduce E/M code burdens

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The American Medical Association is giving high marks to a proposal by the Centers for Medicare and Medicaid Services to reduce the burden of Evaluation and Management codes on physicians.

E/M coding is the process by which physician-patient encounters are translated into five-digit Current Procedural Terminology (CPT) codes, which are submitted for payment.

In a proposed rule released this week, CMS is seeking changes to the Medicare Physician Fee Schedule—effective Jan. 1, 2021—that sets separate payment rates for all five levels of office/outpatient E/M visit CPT codes rather than blending payment rates for certain levels, as was finalized last year.

“One provision that stands out is the change for documenting and coding office visit evaluation and management (E/M) services for implementation in 2021,” said AMA President Patrice Harris, MD, noting that earlier this year an AMA-convened CPT Editorial Panel approved revisions to the CPT E/M office or other outpatient visit reporting guidelines and code descriptors.

Also See: Physician groups support CMS plan to streamline E&M documentation

The AMA contends that the revisions from the CPT Editorial Panel are “in lock step” with the already established burden relief initiatives established by CMS.

“Developed in partnership between the AMA and CMS and with broad input from the medical community, the proposal reflects the increasing complexity of these services and the resources required to provide them, and represents a significant step toward reducing administrative and documentation burdens in medicine,” added Harris.

According to Harris, the proposed changes from CMS to documenting and coding for office visits will “streamline reporting requirements, reduce note bloat, improve workflow and contribute to a better environment for healthcare professionals and their Medicare patients.”

AMA has created a website that provides background and instructional information on the new E/M code revisions and shows how it will differ from current coding requirements and terminology.

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