Enduring CME Course: Can Physicians Bill for Both Preventive and Evaluation and Management (E/M) Services During the Same Visit?

Activity ID

11136

Expires

December 15, 2025

Format Type

Enduring

CME Credit

0.25

Fee

$30

CME Provider: American Medical Association

Description of CME Course

When a patient is seen for a physical or preventive/wellness visit, and also has acute complaints or chronic problems that require additional evaluation, some physicians encounter challenges when coding and billing for both services. There is confusion about whether it is permissible to bill for acute or chronic care, as well as the preventive service, in the same visit. Sometimes physicians are advised that they cannot bill for both services. Other times they are told they can bill for both but will only receive payment for one, and sometimes there is patient push back when they receive a billing statement with charges they were not anticipating.

Disclaimers

1. This activity is accredited by the American Medical Association.
2. This activity is free to AMA members.

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ABMS Lifelong Learning CME Activity

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Preventive Medicine

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More Information

Commercial Support?

NOTE: If a Member Board has not deemed this activity for MOC approval as an accredited CME activity, this activity may count toward an ABMS Member Board’s general CME requirement. Please refer directly to your Member Board’s MOC Part II Lifelong Learning and Self-Assessment Program Requirements.

General Information on CME Activity

Educational Objectives

1. Describe the myth or issue that impacts physicians and their care teams
2. Explain what existing regulatory policies indicate about coding and billing for both preventive and problem-focused E/M services when they are performed during the same appointment

Keywords

Medical Coding, Health Care Economics, Insurance, Payment

Competencies

Medical Knowledge

CME Credit Type

AMA PRA Category 1 Credit

DOI

10.1001/ama.2022.0000730