HCCIntelligence™ Premier Webinar: Mastering E/M Coding & Documentation-HCCI Superbill

HCCI Superbill_2022

Pdf Summary

This document outlines various medical services and their associate CPT codes, work RVUs (wRVU), Medicare National Fee Schedule payments, and adjusted payments for Nurse Practitioners/Physician Assistants at 85% of the Medicare allowable rate. The services are categorized based on the setting: DOM (domiciliary), HOME (home), SNF (skilled nursing facility), and other procedural categories.<br /><br />Key service categories include:<br /><br />1. **Domiciliary Services**:<br />   - Levels 1-5 for both new and established patients, based on history, exam, and Medical Decision Making (MDM) complexity (CPT codes 99324-99337).<br />   - Differences in time and payment from simple (20 minutes) to complex (75 minutes) evaluations.<br /><br />2. **Home Services**:<br />   - Similar structure to DOM, covering levels 1-5 for new and established patients (CPT codes 99341-99350).<br /><br />3. **Prolonged Services**:<br />   - Provided across different settings, including face-to-face and non-face-to-face contexts (CPT codes 99354-99359).<br />   - Specific codes for additional 30-minute increments.<br /><br />4. **Care Plan Oversight**:<br />   - Home health and hospice care management requires dedicated billing time per calendar month (CPT codes G0181, G0182).<br /><br />5. **Chronic Care Management (CCM)**:<br />   - Basic and complex CCM services ranging from 20 minutes to more advanced care requiring significant patient management time (CPT codes 99490, 99439, 99491, 99487, 99489).<br /><br />6. **Telehealth and Remote Monitoring**:<br />   - Includes virtual check-ins, remote patient monitoring, and online digital services (CPT codes G2010, G2250, 99453-99458).<br /><br />7. **Interprofessional Consultations**:<br />   - Services provided via telephone/internet for consulting and referring physicians (CPT codes 99446-99452).<br /><br />8. **Behavioral Health**:<br />   - Integration and consultation services for chronic and acute behavioral health needs (CPT codes 99484).<br /><br />9. **Transitional Care Management (TCM)**:<br />   - Post-discharge transitional care with moderate to high MDM (CPT codes 99495, 99496).<br /><br />10. **Procedural Codes**:<br />    - Various outpatient procedures including joint injections, biopsies, and routine venipunctures (CPT codes 51701, 69210, 43762, etc.).<br /><br />Detailed fee schedules and wRVUs are provided for each service, helping to delineate the complexity and reimbursement structure across different healthcare settings.

Keywords

medical services

CPT codes

work RVUs

Medicare payments

Nurse Practitioners

Physician Assistants

domiciliary services

home services

chronic care management

telehealth