2023 final Medicare fee schedule: CMS poised to accept most AMA E/M revisions, with a few asterisks

Why This Topic Matters

The article helps readers understand where Medicare will follow the revised AMA E/M structure and where Medicare-specific billing and reporting policies still apply. That distinction can affect visit selection, place of service reporting, and how practices track services across settings.

Article Sections

1. Overview of CMS alignment and differences with revised E/M guidelines

   Introduces the scope of CMS’s final rule and summarizes the broad areas where Medicare follows the revised E/M framework and where it departs from it.

2. Facility stay, specialty, and non-physician practitioner policy

   Covers Medicare’s approach to facility stays, specialty distinctions, and how non-physician practitioners are treated under the final policy.

3. Observation/inpatient-specific policies

   Discusses Medicare policies affecting observation and inpatient services, including stay status changes, same-day services, and place of service reporting.

4. Nursing facilities

   Summarizes final rule changes and continuing policies for nursing facility assessment visits, related same-day services, and reporting flexibility.

5. CMS bids grudging goodbye to 99318

   Addresses the final rule discussion of the annual nursing facility assessment visit and Medicare’s decision regarding its future reporting.

6. Medicare OK with merged residential codes

   Covers the updated home and residence visit code structure and Medicare’s acceptance of the merged residential code families.