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...•Step 4) Bill the appropriate level of service −Most often will be 99213 (level 3) or 99214 (level 4) •Step 5) Add the appropriate billing code for the number of regions treated, with -25 modifier −98925 1-2 regions −98926 3-4 regions −98927 5-6 regions −98928 7-8 regions −98929...


AAFP Comment Letter on 2019 Final Medicare Physician Fee Schedule - December 28, 2018

...and that the physician personally spent the current typical time for the CPT code reported (e.g., 15 minutes when reporting CPT code 99213). We support this plan and strongly urge CMS to implement it in 2020. This is the same approach now used when physicians code based on time...



...Q When providing group visits, can we code based on time? A In general, the AAFP advises that you report an E/M code, such as 99213, for a patient seen in a group setting as long as your documentation supports that you provided the key components of the code. In other words, the...

Family Practice Management


...the Centers for Medicare and Medicaid Services (CMS) said a physician could furnish a medically necessary face-to-face E/M visit (CPT code 99213 or similar code depending on level of service) to a patient that is observed by other patients. The agency added that none of the...

Family Practice Management


...Q Regarding transitional care management codes 99495 and 99496, if we see the patient for a 99213- or 99214-level service before the end of the 30-day period, can we bill for that visit at that time and then bill the 99495 after the 30 days? A The first face-to-face visit with...

Family Practice Management


...What CPT code is used for a telephone visit? Is it 99213 or does that require video? Medicare covers telephone visits through Healthcare Common Procedure Coding System (HCPCS) code G2012 and CPT codes 99441-99443. Medicare requires audio-video for office visit E/M...


...for the telephone services codes (99441-99443). Whether we will be able to achieve parity in payment with face-to-face services, such as 99213-99215, is unknown. In the meantime, we appreciate that CMS has begun to cover and pay for telephone services, thus aiding family physicians’...


...Can the AAFP confirm that Medicare will pay codes 99213 and 99214 for telehealth visits? Yes, use Place of Service Code 02 (Telehealth). A full list of Medicare Telehealth Services is available here. We most likely will see those higher level of services with time base...

AAFP Letter to CMS with Final Comments on the 2019 Proposed Medicare Physician Fee ...

...patient office visit in counseling/coordination of care and chooses to code on the basis of time, the physician should select code 99213 (typical time of 15 minutes) rather than 99214 (typical time of 25 minutes), because the total time of the encounter did not reach the threshold...


Coding & Documentation - Nov 2002 -- FPM

Dec 1, 2002 - ...Medicare will allow you to submit G0101 in addition to an evaluation and management (E/M) service (e.g., 99213) if the E/M service is significant and separately identifiable from the G0101 service. An example would be if an established Medicare patient with chronic essential...

Family Practice Management : Coding & Documentation

Coding and Documentation Made Easier -- FPM

Apr 1, 1998 - The author's physician-friendly tool can help you to code more confidently.

Family Practice Management : Articles

An Easy Way to Analyze E/M Coding for Group Practices -- FPM

Aug 1, 2002 - The author describes how practices can analyze their CPT coding distributions and determine whether they are billing for an appropriate range of services.

Family Practice Management : Articles

Ask FPM - Mar 2000 -- FPM

Mar 1, 2000 - Medicare and many other third-party payers to determine physician reimbursement, a level-III established patient office visit (i.e., code 99213) has a total of 1.29 RVUs assigned to it. Under RBRVS, a code's total RVUs is the sum of three components: work RVUs, practice-expense...

Family Practice Management : Q&As

Test Your Coding Skills -- FPM

Feb 1, 2002 - Go head to head with our review panel in coding six troublesome progress notes.

Family Practice Management : Articles

Using Peer Review for Self-Audits of Medical Record Documentation -- FPM

Apr 1, 2000 - You might be surprised at how much doctors can help one another improve in coding and documentation.

Family Practice Management : Articles

Answers to Your Questions on Solo, Idealized Practice -- FPM

May 1, 2002 - How does a solo doc with no support staff manage his referrals, order his supplies and give immunizations? Gordon Moore, MD, answers those questions and more.

Family Practice Management : Articles

House Calls: Taking the Practice to the Patient -- FPM

Jun 1, 2000 - Visiting patients where they live is not only good medicine and good marketing. It's also good for the soul.

Family Practice Management : Articles

11 Tips for More Productive Billing -- FPM

Mar 1, 2002 - The author, a practice administrator, offers 10 tips for improving the efficiency of billing and collection processes.

Family Practice Management : Articles

Should You Modify Your Use of Modifiers? -- FPM

May 1, 1999 - This article explains how to use modifiers commonly attached to CPT codes for family physicians' services.

Family Practice Management : Q&As

Letters - Feb 2002 -- FPM

Feb 1, 2002 - ...My experience is that most physicians believe a normal visit starts at 99213 and that something special must be done to get to 99214. The majority of visits to family physicians involve either working up new health problems or following up multiple medical problems. I don’t know how...

Family Practice Management : Letters

Monitor - Jan 2002 -- FPM

Jan 1, 2002 - ...receive small increases: 99211 (1.9 percent), 99212 (0.67 percent), 99214 (0.13 percent) and 99203 (0.56 percent). Reimbursement for code 99213 is scheduled to drop by 0.36 percent. At press time, efforts are underway in Congress to stop the reimbursement cuts and require that a new...

Family Practice Management : News Briefs

Coding an Annual Assessment for a Nursing Home Patient -- FPM

Mar 1, 1998 - The author analyzes the documentation of an annual assessment of a nursing home patient and the completion of the MDS/RAI.

Family Practice Management : Coding Challenge

Making Quality and Service Pay: Part 1, The Internal Environment -- FPM

Oct 1, 2000 - Insurers may not explicitly reward your practice for improved quality and service, but there is a way to make quality and service pay.

Family Practice Management : Articles

Coding & Documentation - Apr 1999 -- FPM

Apr 1, 1999 - ...Can I code 99455 for a work-related or medical disability evaluation as well as a regular office-visit code (such as 99213) for the same encounter, if it's appropriate? A Yes. Code 99455 is one of three used to report evaluations required for life or disability insurance...

Family Practice Management : Coding & Documentation

Planning Group Visits for High-Risk Patients -- FPM

Jun 1, 2000 - You'll not only have more satisfied patients and better compliance, but you'll also be compensated for your services.

Family Practice Management : Articles

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