Coming in 2021: A 10% cut to the conversion factor, E/M revisions remain on track

Why This Topic Matters

The article helps readers understand which parts of 2021 Medicare payment policy changed for common office-based services and which program deadlines or flexibilities remained in flux. That makes it relevant for planning reimbursement, workflow, and coding updates across multiple specialties.

Article Sections

1. Conversion factor update and budget neutrality

   Overview of the 2021 Medicare physician fee schedule payment update and the budget-neutrality context behind it. Includes broad implications for physician reimbursement.

2. CF cuts balance E/M gains

   Discussion of the relationship between office/outpatient E/M valuation changes and the overall payment impact on specialties. Covers general changes in relative value units and their effect on reimbursement trends.

3. E/M documentation changes on track

   Summary of the 2021 E/M office visit documentation approach and the shift in how level selection is determined. Focuses on the scope of CMS guidance rather than specific selection details.

4. 2021 E/M office visit fees

   Table of 2021 office and outpatient E/M fee schedule values for new and established patient services. Presents the updated pricing context for commonly billed office visit services.

5. CMS replaces prolonged service code 99417

   Coverage of CMS’s separate approach to prolonged office/outpatient service billing and its related telehealth and reporting considerations. Also notes operational implications for software and payer policies.

6. Visit complexity add-on code arrives

   Introduction of a new visit-complexity add-on service and the article’s discussion of who may use it. Frames the service within office/outpatient E/M changes.

7. Telehealth rules under COVID

   Summary of telehealth-related code policy updates during the public health emergency. Includes categories of telehealth-eligible services and the temporary nature of some flexibilities.

8. Telephone visits get a new interim G code

   Explanation of changes to telephone-based E/M payment and the creation of an interim communication technology-based service. Focuses on the transition away from separate payment for certain phone visit codes.

9. QPP updates: MVP still delayed and more

   Overview of 2021 Quality Payment Program and MIPS changes, including reporting pathways, weights, thresholds, and timing. Highlights delayed implementation of a proposed reporting model.

10. Remote patient monitoring update

    Discussion of remote patient monitoring flexibilities, supervision issues, and new virtual services for non-physician practitioners. Addresses how CMS adjusted monitoring-related policies for the year.

11. Other news and notes

    Additional Medicare billing and care-management updates affecting consent, supervision, and transitional care services. Summarizes smaller policy changes included in the final rule.