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.
The 99205 represents the highest level of care for new patients seen in the office. This is the third most popular code used to bill for these encounters among internist who selected the 99205 level of care for 15.52% of new office patients in 2019. The 2021 Medicare allowable reimbursement for this level of care is $224.36 and it is worth 3.5 work RVUs. This level of care requires high complexity MDM
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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