Average Time

Question: For the E&M codes 99211-99215, I can find the published "typical times," but for productivity benchmarking purposes, what would be the approximate "average actual times" for each of these?

Answer: Most practices I see schedule 10 to 15 minutes for E&M visits with established patients. That is the provider time only.

Since I'm seeing that the thrust of your question concerns productivity and we are talking, I presume, about the times listed in the CPT guidelines, you may find that you earn more revenue per E&M visit if your physicians understand how to code appropriately by time versus complexity.

In the geriatric population, for example, it's not uncommon to spend more time in consultation than in actual treatment. If more than 50 percent of the visit is spent in consultation and the physician notes the time the visit took, he or she may be able to bill a higher level of E&M visit based on time.

The key for you is to make sure everyone knows the rules.

Generally, I'd say that most physicians are already working darn hard, and the easier pickings come from optimizing revenue through better coding and use of support staff than through shoving in another patient a day. Of course, this may not be the case for your practice.