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2026 Gastroenterology Reimbursement and Coding Upd ...
The Other E&M We Do But (commonly) Forget to Bill ...
The Other E&M We Do But (commonly) Forget to Bill For
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Video Summary
The presentation addresses underutilization and billing opportunities related to Evaluation and Management (E&M) services in gastroenterology (GI) practices. It begins with polling data indicating a significant increase in billing for complex new patients, suggesting improved documentation and coding practices possibly due to simplified E&M standards. Despite this, providers are encouraged to review their own billing to ensure accuracy and maximize revenue.<br /><br />The speaker emphasizes the importance of billing for “little” services—such as transitional care management (TCM) following hospital discharge, which offers higher reimbursement for timely, complex follow-ups involving medication reconciliation and appointment scheduling. While telephone service codes were discontinued, newer codes for online patient portal communications (99421-99423) and virtual check-ins (G2010, 98016) exist but reimburse modestly.<br /><br />Other underused opportunities include e-consultations with referring physicians, chronic care management (CCM) for patients with multiple chronic conditions, and principal care management (PCM) for single high-risk conditions, both of which can generate meaningful revenue. The talk highlights newly available remote therapeutic monitoring codes (98979) relevant to GI, such as for patient-managed breath testing devices tied to symptom monitoring, presenting novel cash or reimbursable service options.<br /><br />Overall, the presentation urges GI practices to strategically document and bill a broader range of cognitive, management, and remote services to improve revenue in a climate of procedural fee declines and limited payment reform.
Asset Subtitle
Glenn D. Littenberg, MD, MACP, FASGE
Meta Tag
Concept
EM Coding
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Transitional Care Management
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Chronic Care Management
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Principal Care Management
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Billing
Keywords
Evaluation and Management (E&M)
gastroenterology billing
transitional care management (TCM)
online patient portal codes
chronic care management (CCM)
remote therapeutic monitoring
revenue optimization in GI practices
EM Coding
Transitional Care Management
Chronic Care Management
Principal Care Management
Billing
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