decisionhealth Newsletters, Part B News - 2019 Issue 9 (September)
Ophthalmology, endocrinology on opposite ends of 2021 E/M pay calculations
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Article Overview
This article reviews CMS proposed physician fee schedule estimates focused on how 2021 evaluation and management payment changes were projected to affect specialty payments. It is relevant for coders, billers, and practice leaders who track Medicare reimbursement trends across specialties and want to understand the broad distributional impact of E/M valuation changes. The discussion compares relative gains and losses among specialties and places the estimates in the context of CMS payment modeling.
Why This Topic Matters
Specialties vary widely in their reliance on E/M services, so changes to E/M valuation can shift payment outcomes significantly. Understanding these CMS estimates helps organizations anticipate reimbursement impact and policy-driven changes in specialty revenue patterns.
What You Will Learn
- How CMS projected the effect of proposed E/M payment changes on specialty reimbursement
- Which broad specialty groups were estimated to gain or lose under the 2021 changes
- Why E/M utilization patterns influence the direction of payment impact
- How CMS fee schedule estimates can differ across specialties and years
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice administrators
- Physician groups
- Healthcare reimbursement analysts
Codes Discussed
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