Wiki Commercial Payors & E/M Guidelines

[DermBillers]

Hello!
Has anyone heard if commercial payors (non Medicare Advantage plans) have switched to following the Medicare E/M Guidelines that were put in place back in 2021?
Providers were initially coding Medicare & Medicare Advantage plans with the newer EM Guidelines and then commercial payors based on the previous structure.

Thank you

 

[jkyles]

Hi there, the updated guidelines were issued by the AMA, not Medicare. Private payers adopted the changes to office visits in 2021 and the rest of the level-based codes in 2023.