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Basics of CPT Code 98000, 98001, 98002, 98003 We have entered into 2025 and we have many new CPT codes to use in this year. Synchronous audio-video visit codes are added this year and are based on New and Established patient. Also the time plays an important factor to choose the correct CPT code. Below … Read more
The 2025 CPT code set introduces new codes for synchronous audio-only and audio-video visits between patients and physicians or other qualified healthcare professionals (QHPs). These telemedicine services, which involve real-time communication between the patient and provider, are designed for non-face-to-face encounters and are used when appropriate for patient care, with the patient or their family/caregiver … Read more
Introduction: The major revisions to the coding guidelines for office/other outpatient evaluation and management (E/M) visits (CPT codes 99202-99205 and 99211-99215) were implemented nearly four years ago. While these updates aimed to streamline the coding process, practices continue to encounter challenges in documentation and reporting. Such confusion can lead to improper coding and potential financial … Read more
When deciding whether to perform an Annual Wellness Visit (AWV) in conjunction with an Evaluation and Management (E/M) office visit or as two separate appointments, healthcare providers need to weigh several factors. Each approach has distinct advantages and challenges for both the patient and the provider. 1. Pros of Combining the AWV and E/M Visits … Read more
When coding office or outpatient visits based on time, it is essential to consider the total minutes a physician or qualified healthcare professional spends on various activities, including time spent updating the patient’s medical record. These activities must take place on the same calendar date as the face-to-face encounter. Key Points about Time-Based Coding: Time-based … Read more
Basics of 2025 Telemedicine Codes The 2025 CPT manual introduces 16 new telemedicine codes designed for real-time encounters, which are divided into those conducted via synchronous audio-video connection and audio-only connection. These codes mirror the structure of office and outpatient evaluation and management (E/M) codes. It is essential to note that the services must be … Read more
The 2025 expansion of CPT (Current Procedural Terminology) codes is poised to bring significant changes to primary care practices, with the introduction of 270 new codes, 38 revisions, and 112 deletions. These updates, effective January 1, 2025, are crucial for providers to review in advance to ensure timely reimbursement. On September 1, the American Medical … Read more
In January 2024, the Centers for Medicare & Medicaid Services (CMS) issued guidance regarding the implementation of HCPCS add-on code G2211. This code is designed for office and outpatient (O/O) evaluation and management (E/M) visits that are inherently complex due to the medical care required. G2211 applies when care involves continuous collaboration for a patient’s … Read more
As modifier -FS approaches its third year of active status, it’s important to understand the correct application of this modifier, which dictates payment for split/shared E/M visits. Since its introduction by CMS in January 2022, the modifier has become crucial for accurate billing, helping to prevent overpayments, underpayments, and compliance issues. Here are key tips … Read more
The Centers for Medicare & Medicaid Services (CMS) has finalized several changes that significantly expand the scope of behavioral health services, incorporating new coverage for digital treatments and crisis intervention codes. These updates aim to enhance access to behavioral health care, especially in digital and remote settings, and address evolving patient needs. Key Updates to … Read more