2021 proposed physician fee schedule: Medicare E/M fee increases could trigger big cuts everywhere else

Why This Topic Matters

The proposed rule could alter reimbursement across many services and specialties, making it important for practices to understand the policy areas under review and which code families may be affected.

Article Sections

1. Medicare physician fee schedule overview

   Introduces the proposed rule and its potential effect on physician reimbursement across service types. Summarizes the policy context driving the discussion.

2. E/M valuation changes and budget neutrality

   Discusses changes affecting office visit valuation, the Medicare conversion factor, and projected impacts on different specialties. Also addresses reactions from physician organizations.

3. No E/M revaluation for global codes

   Covers CMS’s position on surgical and maternity-related global services and how the agency is treating those code families in relation to office visit changes.

4. Questions on E/M add-ons continue

   Reviews CMS’s request for feedback on an E/M add-on service and related clarification issues. Notes the broader policy discussion around these services.

5. Adjusted times for new prolonged services code

   Explains CMS’s updated guidance on timing for a new prolonged services code and how the agency is describing the revised threshold approach.

6. Some COVID-19 policies may continue, others will be dropped

   Summarizes proposed post-PHE policy decisions affecting telehealth, remote services, supervision, documentation, and other temporary flexibilities. Includes both extensions and planned rollbacks.

7. Revalued service

   Identifies a potentially misvalued spinal procedure under review and outlines the basis for CMS’s revaluation consideration.

8. Chronic care management updates

   Describes changes to chronic care management reporting and the transition from an add-on code to a CPT E/M code. Notes the associated staffing and time-based framework.