2026 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2025-The Other E&M We Do But (commonly) Forget to Bill For

Video Transcription

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 Evaluation and Management Services

Concept Transitional Care Management

Concept Chronic Care Management

Concept Current Procedural Terminology Code 99495

Concept Current Procedural Terminology Code 99496

Keywords

Evaluation and Management (E&M) services

Gastroenterology billing

Transitional Care Management (TCM)

Chronic Care Management (CCM)

Principal Care Management (PCM)

Remote Therapeutic Monitoring

Online patient portal communication codes

Evaluation and Management Services

Transitional Care Management

Chronic Care Management

Current Procedural Terminology Code 99495

Current Procedural Terminology Code 99496