RevCycle Intelligence March 6, 2023
The share of outpatient visits billed at the two highest complexity levels increased from 24 percent in 2004 to 43 percent in 2021.
Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found.
Healthcare providers can bill outpatient evaluation and management (E/M) claims at five different levels, determining a visit’s complexity.
Level 1 visits have the lowest complexity and require less time or straightforward medical decision-making. Level 5 visits are the most complex cases and require more time or very complex decision-making. Payers typically reimburse providers at a higher rate for more complex cases.
Today's Sponsors
Today's Sponsor