2020 final fee schedule: E/M payments, documentation changes take a step closer to reality

Why This Topic Matters

The rule shifts how office E/M services are documented and paid beginning in 2021, making it important for practices that need to update workflows, educate staff, and anticipate reimbursement changes across specialties.

Article Sections

1. Documentation changes

   Summarizes CMS’s finalized direction for office/outpatient E/M documentation and the overall timing of the change. It also notes the scope of services affected and the general framework referenced in the rule.

2. Code deletion

   Covers the removal of a newly established office visit code and the effective date of that change.

3. Revised documentation standards

   Describes the update to CPT editorial guidance and interpretive materials for office E/M services, including the introduction of revised support tools for code selection.

4. Add-on code approved

   Discusses approval of an office E/M add-on payment code and its intended role in the fee schedule changes.

5. Prolonged service code approved

   Summarizes approval of a prolonged service code for office visit reporting and its relationship to time-based E/M services.

6. 2021 payments: Risers and fallers

   Reviews the projected redistribution of office E/M payments across specialties and the budget-neutral effects described in the final rule.

7. No change to global surgery values

   Explains CMS’s decision not to revise global surgery valuation to incorporate the updated office E/M values at this time.

8. The future of MDM

   Addresses CMS’s discussion of possible future refinement to medical decision-making guidance and broader implementation concerns.