E/M Updates

Updated: Jan 4


More updates regarding E/M codes for 2021.


Anthem Bluecross and Blueshield of Maine has provided the following latest guidelines:


  • CPT code 99201 (new patient E/M) will be a deleted code.

  • CPT codes 99202 through 99215 (new/established E/M) definitions have changed. Selection of these E/M codes can now be based on either medical decision making or time.

  • CPT code 99417 (prolonged services) and HCPCS code G2212 (prolonged services) will be recognized as billable codes. These codes will be payable based on our existing Prolonged Services policy, which will be updated to reflect the new code along with the modifications to existing prolonged service codes CPT codes 99354 and 99355.

  • HCPCS code G2211 (complexity inherent to evaluation and management associated with primary medical care) will not be separately reimbursed for this service. We will be updating our Bundled Services and Supplies policy to reflect this position.

Find out more by going to www.anthem.com.


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