Evaluate and Manage Services of Teaching Physicians: MM11171

This article is meant to instruct physicians regarding the billing of Medicare Administrative Contractors (MACs) to evaluate and manage services imparted to Medicare beneficiaries.

It is a documentation policy change related with teaching physicians involved in imparting evaluation and management services. It is a clarification for the existing language manual to teach physicians and evaluation and management of services.

The medical coders have to implement the changes. There will be no search by MACs for claim reprocessing striking with this modification. Claim adjustment will be done if medical coders will share the relevant information with MACs.

To get the payment related with teaching physicians regarding evaluation and management services must need some documentation which involves the following:

  •  Physical presence of physician
  •  Participation of physician in patient management
  •  Participation level of physician in analysis and control of services which must be reflected in
  •  Patient medical record
  •  Notes prepared by residents, physicians, or nurses

This change is implemented with effect from 29 July 2019.