The Centers for Medicare and Medicaid Services (CMS) recently released the evaluation and management (E&M) guidelines for calendar year 2023. These new changes to the guidelines will affect how healthcare providers document and submit claims for E&M services. It is important for providers to understand the changes and how they will impact their practice.
What Are Evaluation and Management Services?
Evaluation and management services are services provided to a patient to assess their condition and determine the best course of treatment. These services can include diagnosis, treatment planning, and/or preventive care. The CMS guidelines are designed to ensure that providers are accurately documenting and submitting claims for these services.
What Are the Changes to the E&M Guidelines?
The new E&M guidelines for 2023 have been updated to include several changes. These changes include:
- The use of time as a factor in determining the level of E&M services.
- The addition of several new codes for services related to medical decision-making.
- The clarification of the documentation requirements for new and established patient visits.
- The addition of several new codes for digital health services.
- The clarification of the documentation requirements for the use of modifier “25”.
- The clarification of the documentation requirements for the use of modifier “59”.
How Will These Changes Impact Providers?
The updated E&M guidelines will have an impact on how providers document and submit claims for E&M services. Providers should take the time to review the new guidelines and understand how they will affect their practice. Additionally, providers should be aware of the new codes and documentation requirements.
What Are the Benefits of These Changes?
The changes to the E&M guidelines are intended to provide more clarity and consistency in the documentation of E&M services. By having clearer and more consistent documentation requirements, providers will be able to submit claims for services more accurately and efficiently. This should help to reduce time spent on paperwork and improve overall patient care.
Conclusion
The new E&M guidelines for 2023 are intended to provide more clarity and consistency in the documentation of E&M services. By taking the time to review the changes, providers can ensure that they are accurately documenting and submitting claims for services. This should help to reduce time spent on paperwork and improve overall patient care.