Revisions to Office or Other Outpatient Evaluation and Management (E/M) Services

Activity description

Beginning January 1, 2021, the Centers for Medicare and Medicaid Services (CMS) will adopt the American Medical Association (AMA) Current Procedural Terminology (CPT©) revisions to office or other outpatient evaluation and management (E/M) services. The goals of these revisions, in part, are (1) to decrease the administrative burden of documentation and coding by decreasing the need for audits and unnecessary documentation in the medical record that may not be pertinent to the individual’s care and (2) to ensure that payment for E/M services is resource-based and that there is no direct goal for payment redistribution between specialties. This activity will discuss these revisions, highlight the elements of medical decision-making (MDM) and time and provide MDM-based and time-based coding examples.

Provided By
This activity is provided by OptumHealth Education.

Commercial Support
This activity is supported by Optum / Optum Care.

Hardware/Software Requirements
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Target Audience

This activity is designed to meet the educational needs of physicians, coders and other health care professionals interested in office or other outpatient E/M services.

Learning Objectives

At the end of this educational activity, participants should be able to:

  • Describe the comprehensive evaluation and management (E/M) revisions that will be effective in 2021.
  • Discuss the elements of medical decision-making (MDM) and time-based coding.
  • Explain the requirements for MDM-based coding and time-based coding.
  • Recall MDM-based and time-based coding examples.

Additional Information

Activity summary
Available credit: 
  • 1.00 AAPC
  • 1.00 AMA
  • 1.00 Attendance
Activity opens: 
09/01/2020
Activity expires: 
12/31/2021
Rating: 
5

Faculty
Amber CrippsAmber Cripps, CPC, CPCO
Associate Director
Optum Clinical Performance
Tucson, AZ

Amber Cripps holds certifications in coding and compliance and she has nearly two decades experience in healthcare coding compliance. Amber is an Associate Director within the Optum Clinical Performance team and she is responsible for managing procedure coding accuracy programs in support of Optum Care.  

Stacy FrisinaStacy Frisina, CPC, COC 
Manager
Optum Clinical Performance
Tucson, AZ

Stacy Frisina is a certified professional and outpatient coder. She began her career in healthcare almost 30 years ago, working in health insurance. Since then she has supervised a claims department, worked in compliance as a Fraud, Waste and Abuse Investigator, and has managed a team of physician educators at a large academic facility in Tucson. She joined the Optum Clinical Performance team 1 year ago as a Manager, supporting Optum Care procedure accuracy programs.

Kevin Kevin Heath, MD, MHL, FACPHeath, MD, MHL, FACP
Medical Director
Optum Clinical Performance
Lawrence, KS

Dr. Heath is board certified in nephrology and internal medicine. He completed medical school and internal medicine residency at Creighton University in Omaha, Nebraska, followed by a nephrology fellowship at Stanford University in Palo Alto, California. He subsequently entered private practice in nephrology in Dallas/Fort Worth, Texas.

P.J. LeadbtterPatrick J. Leadbitter, MPAS, PA-C
Manager of Provider Training and Development
MedExpress Urgent Care
Canonsburg, PA

Originally a paramedic, firefighter and flight paramedic, PJ completed his undergraduate degree in Emergency Medicine at the University of Pittsburgh and completed his Physician Assistant training in 2004 at Chatham University in Pittsburgh, Pennsylvania. He started practicing as a PA in the Emergency Department in 2004 and he started at MedExpress Urgent Care in 2007 as a Physician Assistant and currently is the Manager of Provider Training and Development.

Planners
Sarah Chart, RN
Senior Director
OptumHealth Education
Eden Prairie, MN

Rebecca Gleason, RN, CCM
Activity Manager
OptumHealth Education
Eden Prairie, MN

Disclosures of relevant financial relationships
In accordance with the ACCME Standards for Commercial SupportSM, OptumHealth Education (OHE) requires all those involved in the development of activity content to disclose their relevant financial relationships. An individual has a relevant financial relationship if such person (or his/her spouse/partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest. OHE ensures that the content is independent of commercial bias.

Ms. Chart and Ms. Gleason have indicated that they are employees of and own stock in UnitedHealth Group.

The remaining activity faculty or planners have no financial relationships to disclose.

Method for calculating CE credit
CE credit was calculated by the complexity of content.

Accreditation Statement
Joint LogoIn support of improving patient care, OptumHealth Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the health care team.

Credit Designation Statements
Nurse Practitioners
The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.

Physicians
OptumHealth Education designates this enduring activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

PAs
The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.

AAPC-Certified Coders
This program meets AAPC guidelines for 1.0 CEU. Can be used for Core A, CANPC and CHONC with successful completion of post-test for continuing education units.

Attendance
A certificate of attendance will be provided to learners upon completion of activity requirements, enabling participants to register with licensing boards or associations that have not been pre-approved for credits. To apply for credit types not listed above, participants should use the procedure established by the specific organization with which they wish to obtain credit.

Available Credit

  • 1.00 AAPC
  • 1.00 AMA
  • 1.00 Attendance
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