Overview
Evaluation and management (E/M) services are cognitive (as opposed to procedural) services in which a physician or other qualified healthcare professional diagnoses and treats illness or injury. Nearly all physicians provide E/M services, however most services that infectious diseases physicians provide are of the E/M type. Appropriate documentation and coding of E/M services are vital to capturing the medical services provided to infectious diseases patients and therefore are also vital for appropriate reimbursement and compensation. IDSA has curated resources for ID physicians and their staff to assist in a better understand E/M coding.
Updated Evaluation and Management Services Reference Guide
Over the past years, the Centers for Medicare & Medicaid Services has made significant revisions to evaluation and management services, allowing physicians to select the E/M visit level to bill based on either total time spent on the date of patient encounter or the medical decision making used in the provision in the visit. In 2022, changes were established for the office and outpatient setting. In 2023, reforms extended across all health care settings including hospitals, emergency departments, nursing facilities and patients’ homes. 2024 brings an add on complexity code G2211 and split or shared visits. To learn more, check out IDSA’s 2024 Evaluation & Management Services Reference Guide, designed to educate ID physicians on these important changes. More resources and tools to come in 2024!
For additional resources, please check out the CMS E/M guide here, along with a Code G2211 Fact Sheet from CMS.
New Webinar: CPT Code G2211 for ID Physicians
Dr. Timothy Sullivan, Vice Chair of IDSA’s Coding & Payment Subcommittee and Dr. John Fangman, member of both HIVMA and IDSA’s Coding & Payment Subcommittee, discuss the new G2211 code, introduced in the 2024 Evaluation and Management Services revisions by the Centers for Medicare & Medicaid Services. In this 10-minute informational video, they discuss how this code can be used by Infectious Diseases clinicians with real world examples. The slide deck used in this video can be found here and the summary of this code from CMS can be found here.
Frequently Asked Questions: IDSA Evaluation and Management CPT Coding Guide
IDSA has prepared an FAQ that answers questions around the new E/M code changes.
Evaluation and Management Resources
- Office/Outpatient Evaluation and Management Services Reference Guide
- Office/Outpatient E/M Services FAQs
- Office and Outpatient E/M Webinar
- CPT® Evaluation and Management
- Revisions to the CPT E/M Office Visits: New Ways to Report Using Time
- Revisions to the CPT E/M Office Visits: New Ways to Report Using Medical Decision Making (MDM)
- Implementing CPT Evaluation and Management Revisions
- Medicare Evaluation and Management Services Guide
Used with permission of the American Medical Association. AMA CPT Professional 2024, ©Copyright American Medical Association 2023. All rights reserved.