Billing by Time

Summary:

Clinicians (not residents) can bill Office Visits based on total time spent, including chart prep, documentation and care coordination done that same day.  Use the Text Macros .bill_by_time_ESTABLISHED_PT  and .bill_by_time_NEW_PT to document this in the text field at the very top of the Assessment and Plan. 

Details:

Clinicians can bill by time for visits as an alternative for billing by medical decision making. The total visit time can include:

• Preparing for the visit, including chart prep, and reviewing data like results and consults
• Direct patient care
• Documentation
• Placing orders, making phone calls, and any other coordination of care tasks

It cannot include anything done by a nurse or other assistant. It cannot include time spent prepping the night before, or completing documentation the day after – time billed must be spent on the calendar day of the visit.  Here is how:

1. Go to the A&P section of the encounter and click in the free text field at the very top:
2. Start typing ".bill" and you will see the text macro choices for billing by time. Choose the correct one (new or established patient):
3. The Text Macro inserts a dropdown.  Click in it, and pick the amount of time you spent.  Each choice shows the correct level of visit to bill:
4. Go to Sign-Off and open the Billing tab as usual. Choose the appropriate level visit in the E&M Procedure Code field.

For more details on the 2021 billing standards:  2021 E&M Coding Guide