The evaluation and management (E/M) patient visit is the core of most family physician practices. Family physicians and other qualified heath care providers can maximize payment and reduce stress associated with audits by understanding how to properly document and code E/M patient visits. Newly updated for 2021.
Accurate and appropriate coding is vital, not only for payment purposes, but for documentation and compliance. Learn the basics of:
Hierarchical condition category (HCC) coding is a risk-adjusted model originally designed to estimate future health care costs for patients. HCC coding helps communicate patient complexity to ensure your payments match the risk of the patients you treat.
Many physicians are interested in providing group medical visits, but as with many other services, coding for group visits requires that billing and coding staff do preliminary work with payers to identify desired coding applications. Learn more about coding for group visits.
In the first days of life a dedicated set of evaluation and management service codes are provided for newborn care, including:
Learn about coding for vaccine administration, including:
There are two main categories of services for which physicians may not get paid by Medicare:
Services not deemed medically reasonable or necessary
Find Advanced Beneficiary Notice Forms in English and Spanish from CMS here.