Proposed physician fee schedule: CMS proposes 11% conversion factor cut, confirms E/M coding overhaul

Why This Topic Matters

The proposed rule could materially change Medicare payment patterns across specialties and alter how practices prepare for E/M documentation and coding updates. Understanding the scope of the proposal helps organizations anticipate reimbursement impact and operational changes before the rule is finalized.

Article Sections

1. Proposed Medicare physician fee schedule changes

   An overview of CMS’s proposed payment updates for 2021, including changes affecting physician and anesthesia services. The section frames the broader reimbursement impact that follows from the proposal.

2. E/M coding overhaul and documentation updates

   Discussion of the planned revisions to office and outpatient evaluation and management coding and documentation. The section addresses the general direction of the revised guideline framework and its expected timing.

3. Payment impact on office visit codes

   A review of projected payment changes for the office visit code set, including current and proposed valuation information presented in the article’s chart. The section also explains why practices may see shifts in reimbursement patterns.

4. Other E/M updates

   Additional CMS proposals affecting related E/M reporting topics, including an add-on code and a prolonged services placeholder code. The section summarizes the areas where CMS is seeking further comment and clarification.