In addition, the time allowed for visits has been expanded in the 2021 E/M guidelines. For example, the CMS allowed 25 minutes for a level 4 established patient, but the new guidelines allow up to 40 minutes, Ms. Chung says. This will allow providers to bill to the highest level of specificity for each visit, she adds, and this change should be beneficial in terms of providers being able to spend needed time on patient care.
Resources at Hand
In the end, the key is to stay informed with the new guidelines to help ensure practices keep running smoothly, claims don’t get rejected and reimbursements continue coming in.
“We encourage practices to use the ACR resources, which have been verified with both the CMS and private payers for what is available to them,” Ms. Chung says. “We hope these will be convenient and valuable resources for practices.”
Members can also contact ACR staff if the information they need isn’t on the ACR website: [email protected].
Kimberly Retzlaff is a freelance medical journalist based in Denver.
References
- Medicare telemedicine health care provider fact sheet. Centers for Medicare & Medicaid Services. 2020 Mar 17.
- American College of Rheumatology. Commercial insurers extend coverage for telehealth services. The Rheumatologist. 2020 Mar 27.
- COVID-19 telehealth services. UnitedHealthcare. 2020 Apr 14.
- COVID-19: Supporting our providers. Aetna. 2020 Apr 13.
- Cigna coronavirus (COVID-19) interim billing guidance for providers. Cigna. 2020 Mar 17.
- Media statement: Blue Cross and Blue Shield companies announce coverage of telehealth services for members [news release]. Chicago, Ill.; BlueCross BlueShield. 2020 Mar 19.
- ACR telehealth provider fact sheet and FAQ. American College of Rheumatology. 2020.
- ACR telehealth coding reference. American College of Rheumatology. 2020.
- Commercial payer temporary health policies. American College of Rheumatology. 2020.
- Robeznieks A. E/M prep: Your in-house practice checklist for 2021 transition. American Medical Association. 2019 Nov 5.
