How Time-Based Billing Impacts Physician Reimbursement for E/M Visits

RevCycle Intelligence September 12, 2022
Victoria Bailey

For 90-minute new patient E/M visits and 45-minute return patient E/M visits, annual physician reimbursement was $409,894 under time-based billing and $188,065 under medical decision-making-based billing.

Time-based billing was associated with higher physician reimbursement for longer evaluation and management (E/M) visits, while billing based on medical decision-making (MDM) led to higher reimbursement for shorter visits, according to a study published in JAMA Network Open.

Under a fee-for-service model, physicians are reimbursed for E/M services based on the number and complexity of problems addressed during a patient’s visit, known as the medical decision-making method.

However, physicians may spend time on tasks that are not reportable under MDM-based billing, such as medical record review, coordination of care, and documentation. This can...

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