2021 Brings Changes to Evaluation and Management Service Guidelines

Written By Alla Levin
March 01, 2021

2021 Brings Changes to Evaluation and Management Service Guidelines

The medical industry is constantly evolving, and E/M guidelines for Medicare are among the changes in 2021. E/M stands for evaluation and management services, and they are the group that handles the documentation, coding, and payment of services rendered. It is important to prepare for the edits to prevent audits.

Increase Cost for Office Visits

Reducing costs in one area always creates an increase in prices elsewhere. Office visits are among many facets that will face a payment increase. The AMA has been working with health professionals for a few years now to streamline documentation of in-person appointments. The goal is to schedule based on need and reduce administrative paperwork. Physicians will have more time to focus on each patient instead of stuck in their office filing documents.

What to Know about the Office-Visit Changes:Management Service Guidelines: Other Service Changes

  • Allow physicians to choose to document based on medical services or total visit time;
  • Eliminates needing to code for time spent performing physical exams and health history;
  • Alter medical decisions from counting tasks to only applying to current condition management tasks.

Many of the changes coming to the E/M guidelines are designed to ease burdens on physicians’ busy work. When clients make appointments, the chief complaint is how late their doctor arrives. Unfortunately, this is not because they are overbooked. They are spending much of their time filling out documentation from the previous client or fixing paperwork errors.

Some are turning to professionals to handle their E&M Generate – Alpha II training to ensure it is properly done.

Management Service Guidelines: Other Service Changes

In addition to office visits, maternity care is also expected to cost more with the changes. However, surgical bundles will remain the same. It is suggested that the cost of office visits be incorporated in the surgery packaging. Remember the goal is to reduce the paperwork, and appointments before and after a surgical procedure are necessary. The guidelines have gone into effect as of January 1, 2021, so the American Medical Association began assisting with the transition last year. However, the adjustments affect everyone from operational to administration departments. Resources are available for all in the medical field. The library includes:

  • CPT Evaluation and Management – historical overview and summary of all revisions made;
  • Checklists with links to prepare practices for office visit changes (including how to simplify the guidelines;)
  • Modules offering a complete overview of all changes to office evaluations (including how they reduce paperwork;)
  • Modules covering different ways to report time spent in the office (including how administration paperwork is reduced;)
  • Modules clarifying definitions and criteria in the updated CPT office visits (focusing on patient care;)
  • Video demonstrations with a detailed tutorial on making changes to your office with new regulations.

No one likes change, and everyone expects to struggle with the adjustments. However, the AMA desires to provide patients with better, more personable care. The only way that is possible is to streamline the paperwork physicians face every day. If this seems like it is a lot to take in, you are not alone. 

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