Oakland Southfield Physicians

OSP News

Priority Health New 2021 Changes to E/M Codes

Posted: 01/14/2021

Effective January 2021, the CPT guidelines for office and outpatient evaluation and management codes (99202-99215) and prolonged services (ie.99354-99356) will change.

The changes only affect office outpatient codes. Observation and inpatient codes remain unchanged. Additional changes you can expect in 2021 include: 

  • CPT guidelines for 1995 or 1997 are no longer used for code selection
  • The requirement to define 3 components for new patient will be removed
  • Code description: Remove language such as "expanded problem focused history", "expanded problem focused examination” and replaced with “medically appropriate history and/or exam".
  • New term descriptors for medical decision making are found in the introduction of the CPT manual.
  • Level determined can based on medical decision making or total face-to-face and non-face-to-face time spent by a Qualified Health Professional.
  • Evaluation and management modifier use and editing does not change.
  • CPT code 99201 has been deleted and will no longer be used.

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