What led to the decline of easy level 3 visits in outpatient care?

The decline of easy level 3 visits in outpatient care can be attributed to several key factors resulting from the changes in billing regulations established by CMS since January 2021. Firstly, the new rules necessitate a focus on either medical decision-making complexity or the actual time spent during patient visits, which have led many providers to migrate toward coding higher-level visits, consequently reducing the frequency of level 3 encounters. Secondly, healthcare regulations and increased documentation requirements have made level 3 visits less viable, as providers are more inclined to opt for higher complexity codes due to the conservative coding practices that emerged following audits and compliance issues.

Additionally, changes in patient demographics that have resulted in more patients presenting with multiple chronic conditions have further complicated the nature of outpatient visits, thereby requiring more thorough examination and care. Lastly, the financial incentives set forth by reimbursement policies favoring complex visits play a critical role, compelling many healthcare providers to focus their practice on higher-tier visits, thus effectively choking off the traditional, straightforward level 3 encounters.