E/M Services: high volume, high risk
Recorded October 19, 2023
According to CMS, E/M services comprise 40% of allowed charges in the physician fee schedule, 20% office visits and 20% other E/M services. Medicare’s expense is medical practice revenue, with the income from some primary care practices comprising 70% or more of total charges.
To protect the organization, compliance professionals can focus on four components of E/M:
- Shared and incident to services,
- Use of modifier 25 with a procedure,
- Wellness and preventive services with a problem-oriented visit, and
- Level of service.
This session will briefly review relevant CMS and CPT rules and provide guidance for oversight for these areas.
After the session participants will be able to:
- Select which components of E/M are priorities for their medical groups
- Review shared and incident to services based on CMS rules
- Assess notes reported with a procedure and modifier 25 for compliance
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*This program has the prior approval of AAPC for 1 continuing education credit. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
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