99211 CPT Code: Know Your Codes
99211 CPT Code Description
99211 CPT Code: Office or other outpatient visit for the evaluation and management of an established patient, that may not require the presence of a physician or other qualified health care professional. Usually, the presenting problem(s) are minimal. You use 99211 if clinical staff members perform the face-to-face visit under the supervision of the physician or other qualified healthcare professional. You might have noted that the updated 2021 code descriptor does not include the time reference for CPT Code 99211 that was in the 2020 descriptor.
An established patient is one who has received professional services from the physician/qualified health care professional or another physician/qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years. In the instance where a physician/qualified health care professional is on call for or covering for another physician/ qualified health care professional, the patient’s encounter will be classified as it would have been by the physician/qualified health care professional who is not available.
Office/Outpatient E/M Coding (99202-99215) Changes in 2021
Effective with the date of service Jan. 1, 2021, the American Medical Association (AMA), which holds copyright in CPT®, and the Centers for Medicare & Medicaid Services (CMS) implemented major revisions related to office and outpatient E/M codes 99201-99215 in 2021. For complete information regarding all CPT codes and descriptions, refer to the 2021 edition of Current Procedural Terminology, published by the AMA. The stated goals were reducing administrative burden, improving payment accuracy, and updating the code set to reflect current medical practice.
RVUs for CPT 99211
The following table shows the first-quarter 2021 and fourth-quarter 2020 total RVUs for 99211. MPFS facility RVUs are often lower than non-facility (office) RVUs because when a physician provides services in a facility, the physician is responsible for fewer practice expenses. The final reimbursement amounts for E/M services will depend on more than just these RVUs.
|2020 Q4 RVUs||0.65||0.26|
|2021 Q1 RVUs||0.68||0.27|
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We hope that this article has provided basic guidelines about the 99211 CPT code. If you are looking for overall billing and coding services you can refer to E2E Medical Billing Services. Our accurate and affordable billing services will eliminate billing and coding errors and will increase your practice collection. To know more about our medical billing and coding services, call us at 888-552-1290 or write to us at info@e2eMedicalBilling.com