HCPro, JustCoding Outpatient - 2019 Issue 47 (November)
2020 MPFS final rule confirms E/M overhaul, updated rates, new codes, and more
November 18th, 2019
Subscribe or sign in to view the full article.
Article Overview
This article reviews major provisions in the 2020 Medicare Physician Fee Schedule final rule and explains how they affect reporting, payment updates, and selected service categories for Medicare Part B. It is relevant for coders, billing staff, physicians, and practice administrators who need a high-level view of CMS policy changes involving office and outpatient E/M services, care management, telehealth, documentation, and physician practice rules.
Why This Topic Matters
The final rule affects how practices prepare for upcoming E/M reporting changes, monitor fee schedule payment impacts, and track newly added or revised service codes and documentation policies. It also helps readers understand which Medicare policy updates may influence workflow, reporting, and reimbursement planning.
Article Sections
-
2020 MPFS overview and fee schedule updates
Introduces the final rule and summarizes broad payment-related updates for the Medicare Physician Fee Schedule. Covers conversion factor changes and overall context for the year’s policy revisions.
-
CMS confirms 2021 E/M direction
Describes the finalized direction for office and outpatient E/M reporting and the associated valuation updates. Also notes the broader policy context around future payment redistribution concerns.
-
Care management codes
Summarizes new chronic care management coding changes finalized for 2020. Includes the general scope of the new services and the timing of their availability.
-
Additional CCM changes on hold
Explains that some proposed chronic care management revisions were not finalized at this time. Notes that related work is expected to continue in future rulemaking.
-
Online digital evaluations and G-codes
Covers Medicare’s continued plan to cover online E/M and evaluation services and the related reporting considerations for certain clinicians. Focuses on the general category of digital evaluation services.
-
Potentially misvalued codes
Identifies services selected for valuation review in the upcoming year. Discusses the broader review process and the types of services under consideration.
-
Telehealth opioid treatment codes added
Summarizes the addition of telehealth-related services for opioid treatment within a bundled care program. Also mentions related telehealth policy adjustments.
-
Medical record documentation
Reviews documentation policy changes intended to reduce administrative burden. Includes updated expectations for review and verification of notes within the medical record.
-
Primary care add-on codes
Describes the move toward a new add-on E/M code for future use. Covers the broader policy purpose and implementation timing.
-
Shifting prolonged service codes
Explains changes affecting prolonged services without face-to-face contact and the transition to a future code. Focuses on the policy shift rather than operational details.
-
Physician assistants gain leeway
Summarizes finalized policy changes affecting physician assistant practice and documentation of working relationships. Addresses practice-level governance and scope-related requirements.
What You Will Learn
- How CMS framed the 2020 MPFS final rule and its broader payment updates
- What kinds of E/M reporting changes are being finalized for future implementation
- Which service categories received new or revised Medicare coding attention
- How the article positions telehealth, chronic care management, and documentation policy changes
- What practice types and administrative teams may be most affected by the rule changes
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Physicians and clinician groups
- Practice administrators
- Compliance and revenue cycle teams
Codes Discussed
Code Ranges Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com