Effective January 1, 2021, the rules for these encounters have changed. They are now documented using the 2021 E/M guidelines NOT the 1995 or 1997 guidelines.
This is the most popular code used to bill for new patients being seen in the office. Internists selected the 99204 code for 51.93% of these encounters in 2019. The 2021 Medicare allowable reimbursement for this level of care is $169.93 and it is worth 2.6 work RVUs. This level of care requires moderate complexity MDM or a total of 45 - 59 minutes devoted to the encounter on the date of the visit.
For a detailed exploration of the 2021 guidelines including clinical examples of each level of care and a deep dive into the new table of medical decision-making,consider signing up for one of our 2021 update courses here.
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