AMA announces major E/M changes for facility-based services
The American Medical Association’s (AMA) CPT Editorial Panel recently published changes to its E/M Services Guidelines. The update includes code revisions, additions, and deletions, which are scheduled to take effect January 1, 2023.
- Level 1 consultations (99241 and 99251) will be deleted so the codes align with the four levels of MDM. The AMA also cleaned up the guidelines for consult codes, for example, getting rid of “confusing guidelines, including the definition of ‘transfer of care,’” according to a notice on the AMA website.
- Domiciliary, rest home and custodial care codes (99324-99340) will be deleted. Instead, these services will be reported with the home visit codes (99341-99350), which will be revised to describe services in the home or other residences.
- Annual nursing facility assessment code 99318 will be deleted. Instead, the service will be reported with the subsequent nursing facility care service codes (99307-99310). Code descriptors for the nursing facility codes will be revised throughout to reflect the code structure of the office visit codes.
- The guidelines add a new prolonged service code for total face-to-face and non-face-to-face time “provided by the physician or other qualified health care professional on the date of an inpatient evaluation and management service,” such as hospital inpatient or observation care and nursing facility services.
- Prolonged service codes for outpatient services (99354-99355) and inpatient services (99356-99357) will be deleted. When appropriate, practices will report prolonged service code 99417 with outpatient codes and the new prolonged service code with inpatient codes.
Editor's note: Some information in this article originally appeared on Part B News.