{"id":21480,"date":"2021-01-28T15:45:39","date_gmt":"2021-01-28T20:45:39","guid":{"rendered":"http:\/\/www.carecloud.com\/continuum\/?p=21480"},"modified":"2025-10-22T11:01:19","modified_gmt":"2025-10-22T11:01:19","slug":"what-you-should-know-about-changes-in-e-and-m-coding","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/what-you-should-know-about-changes-in-e-and-m-coding\/","title":{"rendered":"What You Should Know About E &#038; M Coding Changes"},"content":{"rendered":"<h2>Important Information Regarding E&amp;M Coding Changes<\/h2>\n<p><span data-contrast=\"auto\">The Centers for Medicare &amp; Medicaid Services (CMS) recently updated the 2024 Evaluation and Management (E&amp;M) coding changes, which healthcare providers must be aware of to correct the documentation and billing. The changes are intended to simplify coding procedures, reduce administrative burdens, and accelerate efficiency. Outpatient visit documentation has been revised, time-based coding has been improved, and codes 99202 through 99215 have been refined. These updates mean healthcare providers need to keep up with standard CMS practice and optimize their revenue cycle management and patient care processes to show for the coming year.<\/span><\/p>\n<h2>WHAT IS CHANGING?<\/h2>\n<p><span data-contrast=\"auto\">One of the most significant changes is the elimination of code 99201, which has been seldom used in the healthcare industry. However, while codes 99202 through 99215 have been revised, the complexity of coding levels remains unchanged.<\/span><\/p>\n<p><span data-contrast=\"auto\">CMS has also proposed changes to outpatient visits, introducing two distinct categories: one for existing patients and another for new patients.<\/span><\/p>\n<ul>\n<li data-leveltext=\"?\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;?&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"1\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">Current patients:<\/span><\/b><span data-contrast=\"auto\"> Updates should be recorded by the provider only from the patient&#8217;s most recent outpatient visit, eliminating the need to re-document medical histories already covered by other practitioners.<\/span><\/li>\n<\/ul>\n<ul>\n<li data-leveltext=\"?\" data-font=\"Symbol\" data-listid=\"3\" data-list-defn-props=\"{&quot;335552541&quot;:1,&quot;335559685&quot;:720,&quot;335559991&quot;:360,&quot;469769226&quot;:&quot;Symbol&quot;,&quot;469769242&quot;:[8226],&quot;469777803&quot;:&quot;left&quot;,&quot;469777804&quot;:&quot;?&quot;,&quot;469777815&quot;:&quot;hybridMultilevel&quot;}\" aria-setsize=\"-1\" data-aria-posinset=\"2\" data-aria-level=\"1\"><b><span data-contrast=\"auto\">New patient:<\/span><\/b><span data-contrast=\"auto\"> If the ancillary staff has already documented complaints or medical history for an outpatient visit, billing providers do not need to re-document these; however, the billing provider may review and update the information as required.<\/span><\/li>\n<\/ul>\n<p><span data-contrast=\"auto\">Moreover, <a href=\"https:\/\/www.carecloud.com\/continuum\/medicare-advantage-plans\/\">Medicare<\/a> requires that providers who bill based on time follow the new coding rules and spend more than 50% of their time on counselling and coordination.<\/span><\/p>\n<h2>CURRENT PROCEDURAL TERMINOLOGY (CPT) AND MDM<\/h2>\n<p><span data-contrast=\"auto\">The AMA has proposed new CPT code descriptors for office and outpatient services, applicable to new and established patients. These codes can be used based on the time spent during the encounter or the level of medical decision-making involved.<\/span><\/p>\n<h3>Simplified Outpatient Visit Documentation<\/h3>\n<p><span data-contrast=\"auto\">CMS has simplified docketing for outpatient visits, specifying different rules for new and existing patients. Updates only require the provider to document based upon the latest visit and do not have to re-document previous medical histories for existing patients. For new patients, ancillary staff can record medical history and complaints, which billing providers can check and correct at their discretion. It decreases redundant documentation while increasing productivity.<\/span><\/p>\n<h3>CPT Code Updates for 2024<\/h3>\n<p><span data-contrast=\"auto\">New CPT code descriptors have been added by the <a href=\"https:\/\/www.carecloud.com\/continuum\/qa-with-american-medical-associations-christopher-khoury\/\">American Medical Association (AMA)<\/a> for office and outpatient services for new and established patients. These codes are then interchangeable depending on the time spent in the encounter on the day or the level of medical decision-making necessary.<\/span><\/p>\n<h3>Time-Based Billing Requirements<\/h3>\n<p><span data-contrast=\"auto\">New rules apply to healthcare providers who bill based on time. If time-based billing requires a provider to spend over 50% of the time on activities like counseling, coordinating care, or giving direct patient care, then that is considered time-based billing. That helps providers bill accurately for time spent providing patient care for more complex cases.<\/span><\/p>\n<h3>Compliance using Technology<\/h3>\n<p><span data-contrast=\"auto\">As healthcare providers stay compliant with these new changes, advanced tools like <a href=\"https:\/\/www.carecloud.com\/medical-billing-services\/\">Care Cloud&#8217;s billing<\/a> rules engine automatically flag claims for errors before they are submitted. This Technology facilitates accurate claims processing and avoids administrative errors, which are crucial in the new coding environment.<\/span><\/p>\n<h4>Conclusion<\/h4>\n<p><span data-contrast=\"auto\">E&amp;M coding requires healthcare providers to prepare and understand how the model is revised, simplify outpatient visit documentation, and use the new CPT code descriptors. If you are familiar with these updates, it will be a smoother billing process, and this facility will meet CMS standards. Specifically, by tapping into existing revenue cycle management tools like automated billing, providers can keep revenue cycle management running efficiently and accurately.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Important Information Regarding E&amp;M Coding Changes The Centers for Medicare &amp; Medicaid Services (CMS) recently updated the 2024 Evaluation and Management (E&amp;M) coding changes, which healthcare providers must be aware of to correct the documentation and billing. The changes are intended to simplify coding procedures, reduce administrative burdens, and accelerate efficiency. Outpatient visit documentation has [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":43411,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[71,37,389,4,69],"tags":[409,410],"class_list":["post-21480","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-leadership","category-regulations","category-resources","category-revenue","category-show","tag-em","tag-em-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>E&amp;M Coding Changes: Essential Updates for Providers<\/title>\n<meta name=\"description\" content=\"Understand E&amp;M coding changes by CMS, including new CPT descriptors, outpatient visit adjustments, and documentation rules for billing accuracy.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/carecloud.com\/continuum\/what-you-should-know-about-changes-in-e-and-m-coding\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"E&amp;M Coding Changes: Essential Updates for Providers\" \/>\n<meta property=\"og:description\" content=\"Understand E&amp;M coding changes by CMS, including new CPT descriptors, outpatient visit adjustments, and documentation rules for billing accuracy.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/carecloud.com\/continuum\/what-you-should-know-about-changes-in-e-and-m-coding\/\" \/>\n<meta property=\"og:site_name\" content=\"Continuum\" \/>\n<meta property=\"article:published_time\" content=\"2021-01-28T20:45:39+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-10-22T11:01:19+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/carecloud.com\/continuum\/wp-content\/uploads\/2021\/01\/What-You-Should-Know-About-E-M-Coding-Changes.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1440\" \/>\n\t<meta property=\"og:image:height\" content=\"887\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"cc_continuum\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"cc_continuum\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/carecloud.com\\\/continuum\\\/what-you-should-know-about-changes-in-e-and-m-coding\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/carecloud.com\\\/continuum\\\/what-you-should-know-about-changes-in-e-and-m-coding\\\/\"},\"author\":{\"name\":\"cc_continuum\",\"@id\":\"https:\\\/\\\/carecloud.com\\\/continuum\\\/#\\\/schema\\\/person\\\/6af17e75a684cc5cd23741e014351348\"},\"headline\":\"What You Should Know About E &#038; 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