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

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