NARHC Forum

Contributor: Helen Law, Dignity Health Lassen Medical Clinic - Red Bluff

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I am receiving mixed responses regarding the documentation changes for the E & M codes to be implemented by CMS on 1/1/21 impacting providers workflow with the documentation( MDM and time spent with the patient) CMS's target audience is the Medicare Fee-For-Service Providers as shown on MLN so it would not impact RHC's as we receive our AIR payment . Do we have to follow the new revised documentation guidelines? 

Contributor: Sheila Goethel, Rural Wisconsin Health Cooperative

AMA is supporting the EM changes effective 1-1-21 - which means these office visit changes will be printed and available in all AMA CPT books.  That being said, payers in our state (WI) have stated that they will acknowledge the revisions if/when printed in the CPT book.  As a result, I feel confident that all providers reporting the office visit codes will be affected by the change.  

Payments will not be in accord with the MPFS, but office visit level assignments will be based on the new definitions.