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)

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

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s