Each year, clinicians have to learn the new Medicare and CMS rules and regulations that affect billing and coding. Many commercial carriers adapt these similar rules as well. In 2021, Medicare/CMS finalized and implemented the first major change for outpatient office billing and coding since the 1990's. Significant changes in 'Evaluation and Management (E&M)' coding started in January 2021. A major goal of this change is to reduce the administrative burden placed on providers and improve the payment accuracy for 'Evaluation and Management' visits in the outpatient setting.  Optometrists will have the choice of coding based upon 'time' or 'medical decision making.' This course will review the lesson learned from these changes and will show you how these changes may affect your Medicare and commercial reimbursement. Strategies to prepare for these changes will be offered. Case examples of the new codes will be presented. In addition, new CPT and ICD-10 codes will be discussed including the current state of Telehealth. In order to survive audits, this course will review the documentation needed to support these changes.

Course Code:



Richard Soden, O.D.



AOA Expiration Date:


Related News

Doctors of optometry challenge reasoning behind proposed Eyeglass Rule changes at FTC workshop

The recent workshop heard testimony from various stakeholders on the potential impact that proposed changes to the Eyeglass Rule might have on consumer choice and the burden on the practices of doctors of optometry and ophthalmology, which are already understaffed and saddled with other federal regulation. The Federal Trade Commission will use the feedback to determine whether to go forward with its recommendations.

Common coding Qs answered

These are the coding questions your colleagues are asking—and the answers from the AOA’s experts could help you.

The heat is on: Ensure patients’ protective eyewear is, too

Some doctors of optometry may see an increase in patients seeking care during the summer months, whether they’re playing sports or battling dry air conditions. Be prepared to share your expertise.