Association of Time-Based Billing With Evaluation and Management Revenue for Outpatient Visits.
JAMA Netw Open
; 5(8): e2229504, 2022 08 01.
Article
in En
| MEDLINE
| ID: mdl-36044213
ABSTRACT
Importance Time-based billing options for physicians have expanded, enabling many physicians to bill according to time spent instead of medical decision-making (MDM) level for fee-for-service outpatient visits. However, no study to date has estimated the revenue changes associated with time-based billing. Objective:
To compare evaluation and management (E/M) reimbursement for physicians using time-based billing vs MDM-based billing for outpatient visits of varying lengths. Design, Setting, andParticipants:
This economic evaluation used 2019 billing data for outpatient E/M codes and 2021 reimbursement rates from the Centers for Medicare & Medicaid Services. Modeling of generic clinic templates was performed to estimate expected yearly E/M revenues for a single full-time physician working in an outpatient clinic using fee-for-service billing. Main Outcomes andMeasures:
Yearly E/M revenues for different patient visit templates were modeled. The standardized length of return patient visits was 10 to 45 minutes, and new patient visits were twice as long in duration.Results:
Under MDM-based billing, increased visit length was associated with decreased E/M revenue ($564 188 for 30-minute new patient visit/15-minute return patient visit vs $423 137 for 40-minute new patient visit/20-minute return patient visit). Under time-based billing, yearly E/M revenue remained similar across increasing visit lengths ($400 432 for 30-minute new patient visit/15-minute return patient visit vs $458 718 for 40-minute new patient visit/20-minute return patient visit). Compared with time-based billing, MDM-based billing was associated with higher E/M revenue for 10- to 15-minute return patient visits ($400 432 vs $564 188). Time-based billing was associated with higher E/M revenue for return patient visits lasting 20 minutes or longer. The highest modeled E/M revenue of $846â¯273 occurred for 10-minute return patient visits under MDM-based billing. Conclusions and Relevance Results of this study showed that the relative economic benefits of MDM-based billing and time-based billing differed and were associated with the length of patient visits. Physicians with longer patient visits were more likely to experience revenue increases from using time-based billing than physicians with shorter patient visits.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Outpatients
/
Physicians
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
JAMA Netw Open
Year:
2022
Document type:
Article