Last Updated: Jan 12, 2021
Per the Medicare Physician Fee Schedule final rule, the Centers for Medicare and Medicaid Services (CMS) adopted the American Medical Association (AMA) CPT® framework for Evaluation and Management (E/M) code level selection for Office and Outpatient visits beginning Jan. 1, 2021.
As part of this framework, Level 1 new patient E/M visit code 99201 will be eliminated. The remaining new patient codes 99202-99205 and established patient codes 99211-99215 are unchanged.
Additionally, selection of the E/M code level will be based on either the total time personally spent by the practitioner on the day of the visit or the level of medical decision-making (MDM). As in the past, history and exam will no longer be used to select the office visit code.
In order to assist our members, the Pennsylvania Medical Society (PAMED) created this reference sheet to simplify the code lookup process.
Get the Reference Sheet
For the full AMA CPT® guidance, click here
PAMED members with questions can also contact our Knowledge Center at 800-228-7823 or KnowledgeCenter@pamedsoc.org.