Wiki 2021 E/M Time Documentation

[joyclifton]

When billing based on Time does the provider's documentation have to be completed the same day as the encounter?

 

[AmandaBriggs]

I don't believe that the guidelines speak to this, but only time spent on the actual date of the encounter counts.

 

[joyclifton]

Thank you, Amanda

 

[csperoni]

Agree, only time the day of the encounter may be counted.
NOTE:
Pre 2021, documentation time was not counted
As of 01/01/2021, you may included time spent documenting as part of the total clinician time. So if your clinician spends 8 minutes of documentation, and it is NOT the date of the encounter, you can't count those 8 minutes. If it is the same day, then you may count those 8 minutes.
This is a good argument to your clinicians to document DAY OF to be paid properly for their work. It could definitely affect the level billed.