PFS Final Rule for 2020

Why This Topic Matters

The final rule affects how several commonly billed service types are reported and valued under Medicare. It is important for organizations that need to update coding workflows, documentation practices, education materials, and fee schedules for the new policy year.

Article Sections

1. Overview

   Introduces the scope of the final rule and notes the effective date for the policies discussed. It also references where readers can find the full federal rule text.

2. Evaluation & Management Services

   Summarizes broad changes affecting office and outpatient evaluation and management services and related policy direction for future years. The section addresses service-level structure, time-based reporting, and revisions tied to work value updates.

3. Telehealth & Virtual E-Visits

   Covers new telehealth-related and digitally initiated service categories discussed in the final rule. It also describes the general billing context and documentation expectations associated with these service types.

4. Supervision for PA's

   Explains the policy update regarding physician assistant supervision and how state law affects oversight requirements. The section also discusses where supervision relationships are reflected in documentation.

5. Student Documentation

   Reviews revisions related to student involvement in documentation and how those notes may support the billable record. The section includes the types of learners referenced in the policy update.

6. Transitional Care Management (TCM)

   Summarizes Medicare policy changes for transitional care management services, including valuation updates and other related service adjustments. The section also notes the continued structure of these care management services.

7. Chronic Care Management (CCM)

   Describes updates affecting chronic care management services and related add-on time reporting. The section also addresses broader clarification around care plan content and use.

8. Principal Care Management

   Outlines the new care management category discussed for managing a single high-risk chronic condition. The section explains the general intent of the services and their relationship to other care management categories.

9. Emergency Room Services

   Reviews valuation changes for emergency department evaluation and management services. The section notes the set of emergency room codes discussed in the final rule.