Who can solve the mystery of the missing level 1 visits?

by Julia Kyles, CPC on Sep 21, 2022
Providers submitted 308,919 Medicare Part B claims for 99201, the level 1 new patient visit in the office or other outpatient setting in 2019. Providers submitted 303,583 claims for the visit in 2020. The following year a few providers who didn’t realize 99201 had been deleted submitted 1,143 claims (PBN 9/21/22 subscription required). Medicare denied every claim.
Did level 2 new patient visits (99202) pick up approximately 300,000 claims in 2021?
They did not, according to the latest data from Medicare. The chart below shows that there were more than 2.8 million claims for 99202 in 2019 and more than 2.4 million claims in 2020. But in 2021 reporting fell again to a little more than 2 million claims.
Medicare Part B claims for 99201 2019-2021
What happened to the visits previously represented by 99201? The data can’t answer that question but there are many possibilities, including:
  1. Level 2 claims would have been even lower but for the addition of the missing level 1 visits.
  2. Practices folded the level 1 visits for new patients into procedures performed on the same day.
  3. Practices reported the visits with another code such as a brief telephone-only visit (99441) or virtual check-in (G2012).
What do you think happened to the level 1 visits? Let us know in the comments.
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