For CY 2014, CMS proposes to do away with the existing 5 levels of visit codes for hospital outpatient clinic, Type A ED, and Type B ED, and replace them with three new alphanumeric Level II HCPCS codes representing a single level of payment for each type of visit. Under the proposal, new code GXXXC would replace HCPCS codes 99201 – 99205 and 99211 – 99215 for all clinic visits for all patients, whether new or established. Similarly, new code GXXXA would replace 99281 – 99285 for all Type A ED visits, and new code GXXXB would replace G0380 – G0384 for all Type B ED visits. CMS proposes to calculate payment rates for each new code on the basis of the total mean costs of Level 1 through Level 5 visit codes obtained from CY 2012 OPPS claims data for each visit type. Existing critical care services codes 99291 and 99292 would not be affected by this proposed consolidation of visit level billing codes. CMS believes this change would reduce hospitals’ administrative burden by eliminating the need for hospitals to develop and apply their own internal visit level guidelines and by eliminating the need to distinguish between new and established patients. CMS also believes this proposal would eliminate any incentive for hospitals to “upcode” or to furnish unnecessary services in order to move a patient into a higher visit level category with greater reimbursement.