decisionhealth Newsletters, Part B News - 2020 Issue 12 (December)
10% conversion factor cut offsets E/M gains, with wild fluctuations on the horizon
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Article Overview
This article explains major 2021 Medicare physician fee schedule updates, with emphasis on how budget neutrality and revised E/M valuations affect physician payment trends. It is relevant to physicians, coders, practice administrators, and specialty groups tracking CMS policy changes, E/M documentation updates, and the broader redistribution of Part B payments.
Why This Topic Matters
The article helps readers understand why payment changes in one service area can alter Medicare reimbursement across many specialties, and why documentation and valuation updates may change expected fees and service mix in 2021.
Article Sections
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Physician payments
Introduces the Medicare Part B conversion factor change and the broader payment redistribution context for 2021.
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Calculation of the CY 2021 PFS conversion factor
Summarizes the conversion factor calculation and adjustment components used in the final physician fee schedule.
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Some rise, others fall
Describes how payment shifts are expected to affect different specialties and summarizes CMS’s response to public comments and budget neutrality concerns.
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Calculation of the CY 2021 anesthesia conversion factor
Provides the anesthesia conversion factor calculation and adjustment framework for 2021.
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Finalized: 2021 E/M documentation changes
Outlines the updated documentation framework for office and outpatient E/M visits and notes related CMS implementation changes.
What You Will Learn
- How the 2021 Medicare physician fee schedule changed payment calculations
- How E/M valuation updates interact with budget neutrality adjustments
- Which broad specialties were expected to see payment increases or decreases
- What documentation framework changes were finalized for office and outpatient E/M services
- How anesthesia payment calculations were affected in the final rule
Who Should Read This
- Medical coders
- Physician practice administrators
- Compliance staff
- Billing specialists
- Physicians
- Specialty societies
Codes Discussed
Code Ranges Discussed
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