E/M Changes in 2021 – Shared Services

The CPT^® book defines shared or split services in 2021.

• Formerly, only defined by CMS
• Now, may be used per CPT® for codes 99202—99215

Split/shared for Medicare: rules haven’t changed for split/shared in place of service 11 (office). However, CMS has removed the sections of the Medicare Claims Processing Manual (100-04, Chapter 12) that relate to shared services, noting that they were removed to be updated. Stay tuned.

• In order to bill split/shared in the office, visit must meet incident to guidelines
• No new problems, no new patients
• Physician must have established plan of care prior to visit, must be following established plan of care, NP/PA must be an expense to the practice
• Other requirements of incident to: physician must stay involved in the plan of care, and be in the office when services are provided

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