Additional CPT codes for Evaluation and Management (E/M) have been added for New Patient services (99202 - 99205) and Established Patient services (99212 - 99215) that address time logging straightforward, low, moderate, and high complexity cases.

CPT Codes have been added for Evaluation and Management services. 8 E/M CPT Codes have been added into the CCM, BHI, and RPM programs and may be used for enrolled and non-enrolled patients. No conditions are required in order to bill for these codes.

The codes can be selected as ‘Task Types’ within the CCM, BHI, & RPM programs. To select a code for your patient, navigate to the Care Management tab within their patient file.

Looking at the container of drop-down menus to the left of the Task Timer, click on the Task Type drop-down and navigate to the subcategories of either ‘E/M New Patient’ or ‘E/M Existing Patient.’

Underneath these subcategories are the ‘Tasks Types’ a provider may choose. Select the task type that is appropriate for the visit with your client(s).

Each code will automatically create a claim with the amount of time logged based on the complexity of the client’s case.

You can view the claim created by these codes and their attached complexity by proceeding to the ‘Billing and Claims’ Tab and viewing the ‘Type’ column with the ‘Ready to Bill’ filter applied.

NOTE: The claims created by these codes do not conflict with existing BHI / CCM / RPM codes. For example, a patient can have both CCM (CPT code: 99490) and an E/M New Patient (CPT code: 99202) claim in the same month. Multiple E/M claims may also be made within the same month.

NOTE: Time added using these additional E/M CPT codes as ‘Task Types’ within TC programs will not contribute to the billable time for care coordination programs. For example, 30 minutes logged as provider time with the task "99204: Moderate Complexity" will create a 99204 claim, but will not add 30 minutes of billable time to the CCM program.

NOTE: These E/M CPT codes are for Providers only and a Care Manager or other non-provider users will not be able to utilize them. A provider must be the user listed in ‘performed by’ option to successfully log time for the E/M CPT code task type.

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