Posted in In The Know Series, Insurance, Payers and CPT reinbursement, Training

CMS and E/M code reimbursement rate effective 01/01/2018 (if approved)

Posted on by KR2Medical Billing

If approved: effective 01/01/2018 the following rates will apply to the E/M codes*: These are the proposed payments from CMS for providers that bill for Medicare patients. The documentation guidelines 1995 and 1995  will still apply towards inpatient Hospital visits and Commercial payers.

HCPCS code Current non-facility payment rate Proposed non-facility payment rate
HCPCS code: 99201 Current non-facility payment rate: $45 Proposed non-facility payment rate: $44
HCPCS code: 99202 Current non-facility payment rate: $76 Proposed non-facility payment rate: $135
HCPCS code: 99203 Current nonfacility payment rate: $110 Proposed nonfacility payment rate: $135
HCPCS code: 99204 Current nonfacility payment rate: $167 Proposed nonfacility payment rate: $135
HCPCS code: 99205 Current nonfacility payment rate: $211 Proposed nonfacility payment rate: $135
HCPCS code Current nonfacility payment rate Proposed nonfacility payment rate
HCPCS code: 99211 Current nonfacility payment rate: $22 Proposed nonfacility payment rate: $24
HCPCS code: 99212 Current nonfacility payment rate: $45 Proposed nonfacility payment rate: $93
HCPCS code: 99213 Current nonfacility payment rate: $74 Proposed nonfacility payment rate: $93
HCPCS code: 99214 Current nonfacility payment rate: $109 Proposed nonfacility payment rate: $93
HCPCS code: 99215 Current nonfacility payment rate: $148 Proposed nonfacility payment rate: $93
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My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC), AAPV Approved Instructor; and an owner of KR2 Medical Billing. I create educational material including blogs, presentations that focus on topics of medical billing, medical coding and reimbursement in healthcare.

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