EVALUATION AND MANAGEMENT
Code Selection Criteria
Question: What criteria will be used to select the appropriate evaluation and management (E/M) office or other outpatient code level starting in 2021?
Answer: One of the most significant changes for reporting E/M services in 2021 is the use of either time or medical decision making (MDM) as the criteria for total time providing services on the date of the encounter.
Code 99201
Question: With the deletion of code 99201 in the 2021 CPT® code set, how should evaluation and management (E/M) services of less than 15 minutes be reported?
Answer: According to CPT® Assistant December 2020, code 99202 should be reported for new patient E/M services of 15 minutes or less:
99202 – Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making.
When using time for code selection, 15-29 minutes of total time is spend on the date of the encounter.
