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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