Practices will be breaking in a new set of E/M guidelines for their visits in a facility starting in January of 2023, according to an AMA official. But you can expect to see the coding and guideline changes sooner than that: CMS wants to have a first look at them by early summer of this year.
Speaking this week at AAPC’s virtual HealthCon, CPT Assistant Managing Editor Leslie Prellwitz confirmed that CMS once again has requested that the AMA release the new guidelines early so that the agency can address them in the proposed Medicare physician fee schedule, which is usually out in early July.
The AMA agreed to that and “we are working on that request,” Prellwitz said. The association expects to post the revised guidelines
on its website by the summer, she added.
AMA complied with a similar CMS request in 2019 for advance release of the 2021 E/M office and outpatient guidelines, “which was pretty remarkable,” she said.
Practices and providers should take advantage of the early release of the new 2023 guidelines to thoroughly read and get accustomed to them before they take effect in January, Prellwitz recommended.
“With 2023, it will be the rest of the E/M section, so definitely carve out the time” to review it, she said. In particular, coding experts advised practices to learn the many new definitions added in the guidelines so they aren't simply coding from the medical decision-making grid without a deeper understanding.
“We get a lot of questions from groups that didn’t really dig into [the 2021 E/M changes] until shortly before the effective date,” Prellwitz observed. “That really set them back.”