Ignore Medicare’s total times for office E/M visits

by Julia Kyles, CPC on Dec 10, 2020
Careful readers of the final 2021 Medicare physician fee schedule noticed that the rule contains total times for codes 99202-99215. But those times don't match the time ranges for the revised E/M codes. For example, Table 20 in the final rule gives 99204 a total time of 60 minutes, but the code’s new descriptor has a time range of 45-59 minutes.
 
Does that mean Medicare has adopted different times for the revised codes?
 
No.
 
Medicare will follow the CPT code times in the descriptors. Total time is a factor Medicare uses to set the rates for codes but it does not impact code selection.
 
So while knowledge of the total time for a code might help you win on health care reimbursement trivia night, practices can ignore it when submitting claims.
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