IMPORTANT INFORMATION
In 2024, revisions have been made to office visit codes 99202-99205 and 99212-99215, specifically eliminating the time "range" in minutes and introducing a single "minimum time threshold" for clinicians billing based on time. This change necessitates clinicians to meet or exceed a specified minimum time for each code, emphasizing the importance of accurate documentation.
The Current Procedural Terminology (CPT) codes serve as descriptors for services provided, including examinations, therapy, X-rays, etc. While some years may bring significant changes, the 2024 adjustments mainly focus on time-based billing for certain office visit codes.
For instance, codes 99202-99205 now indicate a clear "minimum time" requirement, eliminating the previous time range. Documentation should encompass not only face-to-face interactions but also activities integral to the examination, whether before or after direct patient contact.
The updated coding descriptions specify the minimum time to be met or exceeded for code selection. Notably, there's no longer a code 99201, with 99202 serving as the lowest level for a new patient. Code 99211 for an established patient remains unchanged with no time component.
For codes 99202-99205, the minimum time requirements are as follows:
99202: 15 minutes
99203: 30 minutes
99204: 45 minutes
99205: 60 minutes
For codes 99212-99215, the minimum time requirements are:
99212: 10 minutes
99213: 20 minutes
99214: 30 minutes
99215: 60 minutes
It's crucial to document the specific time in the notes when using time to choose the Evaluation and Management (E&M) services. Medical decision-making, as an alternative code selection criterion, is not bound by minimum time requirements.
Additional Factors to Consider:
It's imperative for providers to ensure accurate documentation of timed services to avoid reviews and potential repayments. Time documentation should follow the eight-minute rule, with carriers often preferring time to be documented in "from and to" format (e.g., 9:15 to 9:35 for 20 minutes).
Best,
Yadira Martinez | CEO
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