About a one-third jump for E/Ms in store and increase in anesthesia code 00797 after five-year review

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains a CMS Medicare five-year review affecting selected evaluation and management services, one anesthesia code, and related physician fee schedule values. It is relevant to anesthesiologists, pain physicians, and other medical coders tracking RVU changes, budget neutrality effects, and the timing of proposed versus final fee schedule updates.

Why This Topic Matters

The article helps readers understand which parts of the physician fee schedule are being revisited and why some services may rise while others may be affected indirectly. It is useful for coding and reimbursement professionals who need to monitor Medicare rulemaking and specialty-specific payment changes.

Article Sections

  1. Overview of the proposed review

    Introduces the Medicare proposal and its broad effect on selected evaluation and management services and anesthesia-related payment values.

  2. CMS proposals for five-year review of anesthesia and pain codes

    Presents the review context for a small set of anesthesia and pain-related services and discusses the proposed work value changes at a high level.

  3. Budget neutrality and payment impact

    Describes how the proposal fits within Medicare budget neutrality and what that means for the broader physician fee schedule.

  4. CMS proposals for five-year review of select E/M codes

    Summarizes the evaluation and management services included in the proposal and the general direction of the work RVU changes.

  5. Comment period and next steps

    Notes the public comment timeline and the expected follow-up in the final physician fee schedule rule.

What You Will Learn

  • How CMS uses a five-year review to revisit physician work values
  • Which general service categories are included in the proposal
  • How the proposal relates to Medicare budget neutrality
  • What broader operational impacts may matter to anesthesia and pain practices
  • When comments and final rulemaking are expected

Who Should Read This

  • Medical coders
  • Anesthesiologists
  • Pain management physicians
  • Practice managers
  • Revenue cycle professionals
  • Compliance staff

Codes Discussed

Code Ranges Discussed

  • CPT: 64550–64595
  • CPT: 63650–63688

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