The Centers for Medicare and Medicaid Services (CMS) proposes to adopt the following policies for Office Visits effective January 1, 2021:
- Separate payment for the five levels of Office Visit CPT codes, as revised by the CPT Editorial Panel effective January 1, 2021, and resurveyed by the American Medical Association/Specialty Society Relative Value Scale Update Committee (RUC). This includes deletion of CPT code 99201 (Level 1 New Patient Office Visit) and adoption of the revised CPT code descriptors for codes 99202-99215.
- Elimination of the use of history and/or physical exam to determine code levels.
- Choice of time or medical decision-making (MDM) to decide the code level of Office Visits
The American Academy of Pediatrics will be providing many coding resources to help members prepare for the Office Visit coding changes in 2021, including:
The AAP Pediatric Coding Newsletter, available at https://coding.solutions.aap.org/Coding-Newsletter.aspx.
Previous and upcoming newsletter topics include:
Overview of changes, overview of MDM, overview of time, MDM — problems, MDM — data, MDM — risk, MDM — calculation.
Additional education opportunities include:
The 2020 National Conference & Exhibition will have a session dedicated to the Office Visit codes.
AAP Pediatric Coding Webinars on the Office Visit codes
Coding resources for the Office Visit codes on our Coding @ the AAP web site available to members.
Members and staff may submit questions to the AAP Coding Hotline by emailing firstname.lastname@example.org.