We have got some significant changes for you to go through for the upcoming year. In this article, we’ll discuss the key important highlights of this release coming in 2024!!
Let’s begin the new year with up-to-date information that can help benefit you as a medical billing or coding firm elevate your practice management skills and make your revenue cycle improved.!
The annual update to the CPT code set created 349 editorial changes, including 230 additions, 49 deletions, and 70 revisions. With 11,163 codes that describe the medical procedures and services available to patients, the CPT code set continues to grow and evolve with the rapid pace of innovation in medical science and health technology.
The 2024 version will also be the first to offer Spanish language descriptors for medical procedures and services.
"Providing approximately 41 million Spanish-speaking individuals in the United States with an easy-to-understand description of medical procedures and services can help build a more inclusive health care environment, where language is no longer a barrier and patients can actively engage in their care,"
Lori Prestesater, AMA senior vice president of health solutions said in the release.
Revisions will be made within several subsections of the evaluation and management (E/M) section to standardize the rest of the E/M sections of the CPT code set to decrease providers' administrative burden of documentation as outlined in Medicare's 2023 Final Rule. In addition, a new E/M subsection with new guidelines for split or shared services will be created. The new codes will be structured to align with the current E/M office or other outpatient services code structure.
The following updates will include:
The following E/M codes will be revised in the CPT 2024 code set:
A notable change has been implanted for Shared E/M between multiple Clinicians managing a patient at a time. In CY 2022 carried to 2023 the policy had some flexibilities and Clinicians had options to choose from (history and physical exam, MDM, or Time). For 2024 onwards the split/shared services billing options would be retained to 'Time' spend only, (more than half of the total time spent) to set as who provided the substantive portion of the split/shared service.
Code descriptor revisions are about time.
Clarifications sought by the Centers for Medicare and Medicaid Services also prompted the CPT Editorial Panel to add revisions to the CPT 2024 code set that clarifies the reporting of evaluation and management (E/M) services. The revisions include:
For Nursing Facility Visits, a 5-minute addition has been made as a revision as clear in the descriptions below:
G2211 Visit complexity is inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (Add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established).
G2211 is purposed to have the most interesting development
This add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care. Generally, it will be applicable for outpatient and office visits as an additional payment, recognizing the inherent costs involved when clinicians are the continuing focal point for all needed services or are part of ongoing care related to a patient's single, serious condition or a complex condition.
The new codes will align with the current E/M office or other outpatient services code structure (ie, using time or medical decision-making [MDM]) with separate codes for new and established patient encounters and the addition of a virtual check-in code that could be used to determine whether a patient needs a face-to-face visit.
CMS is finalizing that, beginning in CY 2024, telehealth services furnished to people in their homes will be paid at the non-facility PFS rate to protect access to mental health and other telehealth services by aligning with telehealth-related flexibilities that were extended via the CAA, 2023.
A CPT/RUC Telemedicine Office Workgroup was created to assess and develop appropriate coding guidance for E/M telemedicine office visits performed via audio-visual and audio-only mechanisms. The workgroup determined that a new E/M subsection with new guidelines for telemedicine services will be established in the CPT 2024 code set.
Place of Service Codes for Medicare Telehealth Services. Beginning CY 2024, claims billed with place of service (POS) 10 (Telehealth Provided in Patient's Home) will be paid at the non-facility physician fee schedule rate. Claims billed with POS 2 (Telehealth Provided Other than in Patient's Home) will continue to be paid at the PFS facility rate for non-home originating sites, such as physician's offices and hospitals.
The codes below will be deleted from the CPT 2024 code set:
99459 is a practice expense–only code that captures the direct practice expenses associated with performing a female pelvic exam in the non-facility Office setting during a preventive medicine service (99381-99397) or E/M service (99202-99215). As an add-on code, it should be reported only for the same date of service with the codes listed above.
On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that announces finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2024. The calendar year (CY) 2024 PFS final rule is one of several final rules that reflect a broader Administration-wide strategy to create a more equitable healthcare system that results in better access to care, quality, affordability, and innovation.
By factors specified in law, overall payment rates under the PFS will be reduced by 1.25% in CY 2024 compared to CY 2023. CMS is also finalizing significant increases in payment for primary care and other kinds of direct patient care.
The final CY 2024 PFS conversion factor is $32.74, a decrease of $1.15 (or 3.4%) from the current CY 2023 conversion factor of $33.89.
AltuMED is a Medical Billing Services and Solutions company, with more than 13 years of expertise in the industry. Our coding experts are well-versed and leave no room for error. Partner with us to avoid any coding inaccuracies.
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