Evaluation and Management (E/M)
Documentation Changes:
Important Clarification for House Call Providers
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With many changes coming out recently from CMS, providers and practices can find it difficult to keep track. So, HCCI is providing the following clarifications about one set of changes that has been creating significant confusion among house call providers.
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The new CMS 2021 documentation guidelines for the office Place of Service (POS) allow Evaluation and Management (E/M) services to be billed on time alone or on medical decision making (MDM). Please note these new guidelines apply only to the office visit code set (specifically, CPT 99201-99215).
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Providers are required to continue using the same E/M documentation and coding guidelines as in previous years (either 1995 or 1997 guidelines) when they bill the following (Failure to do so may result in audits and/or penalties):
- Home visits (CPT 99341-99350)
- Domiciliary visits (CPT 99324-99337)
- Skilled nursing facility visits (CPT 99304-99318)
HCCI continues to be an advocate for documentation burden relief and improved reimbursement for providers caring for patients in home and/or domiciliary settings, and we are hopeful the changes introduced this year for office visits will be applied to other settings in the future.
If you have questions about the recent changes in E/M documentation, please contact the HCCIntelligence™ Hotline at 630-283-9222 or email [email protected]. You are also encouraged to check out the HCCI E/M Reference Guide.
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HCCIntelligence™ Resource Center
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HCCIntelligence™ Webinars
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Thursday, February 25, 2021, 4pm – 5pm Central
This webinar will highlight lessons learned by several HBPC programs in administering the COVID-19 vaccine to their patients and household caregivers. It will also describe the logistics and planning you can (and should) be putting into place now to ensure your practice is ‘ready to go’ when you receive vaccines for your patients.
Objectives:
- Describe lessons learned from HBPC programs that have started to administer COVID-19 vaccines to patients and household caregivers.
- Discuss logistics and advance planning steps aimed at enhancing vaccine administration for homebound patients.
- Apply creative partnering solutions to ensure homebound patients receive the COVID-19 vaccine.
Presenters:
- Elizabeth Davis, MD – Medical Director, Rush@Home, Assistant Professor, Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
- Brian Lewis, MD – Associate Chief of Staff, Geriatrics and Extended Care, CLC/1B and Home-Based Primary Care Medical Director, William S Middleton Memorial VA Hospital, Madison, Wisconsin
- Trisha Seys Ranola, PharmD, CDE, BCGP, FAIHM – Home-Based Primary Care Clinical Pharmacist, William S Middleton Memorial VA Hospital, Madison, Wisconsin
- Jeremy Phillips – Chief Executive Officer, Geriatric Specialty Care of Nevada, Reno, Nevada
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Wednesday, March 17, 2021, 4pm – 5pm Central
Objectives:
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Understand how to bring Relational Leadership™ concepts into your day-to-day work.
- Learn the importance of psychological safety and identify ways to build it within teams.
- Gain an understanding of a relational mindset and its importance to leadership.
Presenters:
- Kari Mader, MD, MPH – Trainer, Primary Care Progress and Director of Clinical and Education Innovation, Aurora Community Health Commons
- Kyle Turner – PharmD Trainer, Primary Care Progress and Assistant Professor (Clinical), University of Utah
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Upcoming Education Opportunities |
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HCCI Live Virtual Workshops |
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April 15-16, 2021
Designed for learners considering, or relatively new to, offering HBPC services for patients with complex medical conditions. Both clinical and practice operations topics are featured.
Virtual Workshop Rate: $525 ($100 savings)
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June 24-25, 2021
Designed for experienced HBPC providers and practice staff seeking to advance their knowledge, skills, and productivity in caring for patients with complex medical conditions.
Virtual Workshop Rate: $525 ($100 savings)
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Attend both workshops and save
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Practice Management Tip:
COVID-19 Vaccine Resources
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As the Public Health Emergency (PHE) continues, providers and practices are now challenged to receive, prepare, and administer vaccines to home-limited patients. Here is a list of reliable resources that practices can reference to stay informed on the most current guidelines:
HCCI is also following emerging research from the UK regarding the storage of the Pfizer vaccine. In a recent article, new results suggest the Pfizer coronavirus vaccine no longer needs to be kept at super-cold temperatures.
Practice Operations & Leadership
A few reminders…
- When the government provides COVID-19 vaccine doses to your practice without charge, only bill for the vaccine administration – do not include the vaccine code on the claim if the vaccine is free.
- If you participate in a Medicare Advantage Plan, submit COVID-19 claims to Original Medicare for all patients enrolled in Medicare Advantage in 2020 and 2021.
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If you’re administering the vaccine to people without health insurance or whose insurance does not provide coverage for the vaccine, you can request reimbursement for vaccine administration through the Provider Relief Fund.
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If you missed HCCI’s roundtable discussion on COVID-19 Vaccines during the HCCIntelligence™ January Webinar & Virtual Office Hours, you may access the recording and materials on the HCCI Learning Hub here.
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The Coalition to Transform Advanced Care (C-TAC) has launched “Health & Heart,” a six-part podcast series designed to provide faith- and values-based education, support, and encouragement for people facing serious illness, caregivers and clinicians. The group includes over 100 national leaders of community and faith leaders who work together to ensure that competent, coordinated, culturally-sensitive and diverse care is an integral component of the healthcare provided across all settings for those with serious illness, their family members and their caregivers.
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In partnership with The John A. Hartford Foundation (JAHF), Trust for America’s Health (TFAH) is working to identify and disseminate best practices and policy recommendations to ensure that home-bound older adults and people with disabilities are prioritized for the COVID-19 vaccine. As we know, these individuals typically struggle with transportation and access to technology and may also be socially and geographically isolated. Please share any best practices and policy solutions that are being implemented to ensure vaccine access by this vulnerable population.
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HCCI education and training initiatives including HCCIntelligence™
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This email is an advertisement for the Home Centered Care Institute (HCCI). HCCI is passionately committed to its vision of
transforming our nation’s healthcare system by creating universal access to best practice house calls programs,
to ensure that medically complex patients have access to high-quality care in their homes.
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Home Centered Care Institute
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