Podiatry Coding & Billing Alert

Question: Are there any upcoming revisions or changes to the evaluation and management (E/M) codes for office visits that I should be aware of?

Alaska Subscriber

Answer: Yes. After the extensive changes CPT^® made to the E/M codes and guidelines over the last few years, you’ll be relieved to know that this year’s E/M changes are minimal. But that doesn’t mean they are insignificant.

CPT^® has decided to remove the time ranges from both the new and established office/outpatient E/M codes and replace them with a single total time amount, which is the lowest number of minutes in the current range for each code. This time “must be met or exceeded” according to the new wording that now appears in each of the codes’ descriptors.

For example, 99202 (Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making …) has a current time range of 15-29 minutes. However, beginning Jan. 1, 2024, the provider must meet or exceed 15 minutes of total service time before you can bill this code by time.

In table form, the changes look like this:

Note: CPT^® will not be changing the descriptor to 99211 (Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional), which you will continue to bill for established patients receiving E/M services from a nurse practitioner (NP), a physician assistant (PA), or any other nonphysician practitioner (NPP). The code will also continue to require no level of medical decision making (MDM) or total time for you to document.