2021 Evaluation and Management Leveling Guidelines - Timeline and Office Visit/Outpatient Services Time Guidelines

Oct 14, 2026

2021 Evaluation and Management Leveling Guidelines outlines changes effective January 1, 2021 for CPT E/M office/outpatient services 99201–99205 and 99211–99215, including revised code definitions, updated time and medical decision-making requirements, and the option for clinicians to select the E/M level by time or medical decision making. The agenda covers settings, eClinicalWorks time-based templates and coder tools, and documentation assistance. It also provides support resources, a timeline for activation, and chart audit and compliance review steps.

LanguageEnglish

CategoryGeneral

FormatPDF

Pages39

Reading Time14 min

AccessFree to download

Agenda

What’s Changing?

E/M Coding Assistance

Documentation Assistance

eClinicalWorks Assistance

What to Expect

Support & Resources

2021 E/M Office Visit/Outpatient Services Time Guidelines

2021 Evaluation and Management Leveling Guidelines December 3, 2020 Housekeeping ● Questions? Use the Q and A box on your screen and we will get to as many as we can at the end of the webinar. ● The webinar is being recorded, we will send you the slides and recording once the webinar concludes. Speakers Sydney Powell Marketing & Communications Organizer Marie Moss Medical Coding Audits Instructor Presenter Tiﬀany Richardson eClinicalWorks Trainer Presenter 2021 Evaluation and Management Leveling Guidelines Agenda Marie will cover ● Changes of the Evaluation and Management Oﬃce Visit leveling guidelines ● Time ● Oﬃce Visit and other Outpatient Services code description ● Medical Decision Making ● Social Determinants of Health ● Prolonged Services Tiﬀany will cover ● Settings ● eCW Time Based Template ● eCW V2 Coder ● eCW V2 Coder Triggers GUARANTEED 10% INCREASE IN CASH FLOW. Conquer the New Age of Healthcare Reimbursement Bringing together robust data, intelligent claim handling & performance consulting for a richer revenue cycle. ● Clinical Coding ● Professional Services ● Patient Pay ● Denial Management ● Healthcare Analytics What’s Changing? Eﬀective January 1, 2021 , the American Medical Association CPT codes for office/outpatient services E/M visits 99201-99205 and 99211-99215 will have a whole meaning. CMS has adopted these changes as of Dec. 1st and will soon be sharing the new fees. ● Retains 5 levels of coding for established patients reduces the number of levels to 4 for oﬃce/outpatient E/M visits for new patients, and revises the code deﬁnitions ● Revises the times and medical decision-making process for all of the codes, and requires the performance of history and exam only as medically appropriate ● Allows clinicians to choose the E/M visit level based on either medical decision making or time E/M Coding Assistance Documentation Assistance ● Time-based coding and medical decision making documentation guidelines ● eClinicalWorks Setting Chart Audit and Recommendations ● Identify the risk associated with level of care assignments Compliance Review ● Client + Coding Resource Consultant will meet to review the documentation audit, recommendations, and discuss next steps eClinicalWorks Assistance ● FREE E/M Coder activated for use with versions 10SP2 .5.48 and above ● Assistance with Progress Note Templates What to Expect Timeline for the E/M Coding Changes Today Revele has published E/M coding resources please check our website for education and training. Software conﬁguration, chart audits, 1:1 provider training and leveling practice. E/M changes are active. Revele will provide ongoing support and troubleshoot any post change issues. Support & Resources Helpful Resources To Get You Started ● AMA Quick Links ● Time Audit Cheat Sheet ● YouTube Video of Guidelines 2021 Evaluation and Management Leveling Guidelines 2021 E/M Oﬃce Visit/Outpatient Services Time Guidelines ● Counseling and/or coordination of care no longer has to dominate service. ● Total time on the date of the encounter includes both the face-to-face and non-face-to-face time personally spent by the physician and/or other qualiﬁed healthcare professional(s) . ● The physician or other qualiﬁed health care professional’s time is spent in the supervision of clinical staﬀ who perform the face-to-face services of the encounter, use 99211. ● For shared or split visits select the appropriate level of a service for which time-based reporting spent by the physician and other qualiﬁed health care professional(s) assessing and managing the patient on the date of the encounter is summed to deﬁne total time. When two or more physician(s) and other qualiﬁed healthcare professional(s) meet to discuss the patient, only the time of one individual should be counted. ● When prolonged time occurs, the appropriate add-on code may be reported.

FAQs

When do the E/M office/outpatient CPT code changes become effective?

The changes are effective January 1, 2021 for CPT E/M visits 99201–99205 and 99211–99215, with CMS adopting the changes as of Dec. 1 and sharing new fees soon.

How can clinicians select the E/M visit level under the new guidelines?

Clinicians can choose the E/M visit level based on either medical decision making or time, and history and exam must be performed only as medically appropriate.

What does “total time on the date of the encounter” include for time-based reporting?

Total time includes both face-to-face and non-face-to-face time personally spent by the physician or other qualified healthcare professional(s), and time spent supervising clinical staff performing face-to-face services using 99211.

Oct 14, 2026

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