NGS MAC – JK processes Medicare Part B claims for Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont Read along to get answers!

TIME-BASED SERVICES ON OR AFTER 1/1/2021

This information applies to office and outpatient services (99202-99215) performed on or after 1/1/2021.

1. How do counseling and/or coordination of care count toward billing these services based on time?

Answer: As of 1/1/2021, office and outpatient E/M services may be coded based on time whether or not counseling and/or coordination of care have occurred or have dominated the service. 

2.  Can clinical staff time be counted in calculating time?

Answer: Time spent separately by clinical staff is not included in calculating time. 

3.  What face-to-face provider activities may be counted in calculating time? 

Answer: Time spent on the same date of servicein obtaining and/or reviewing prior history, time spent during a medically necessary examination and time spent in counseling and educating the patient/family/caregiver may all be counted toward total face-to-face time. 

4.  What non-face-to-face provider activities may be counted in calculating time?