Healthcare News: CMS releases CY 2021 MPFS and OPPS proposed rules

Why This Topic Matters

The proposals could affect coding workflows, documentation expectations, and payment levels across multiple specialties and outpatient service lines. Readers tracking Medicare rulemaking will want to understand which policy areas are changing and where comments are being sought.

Article Sections

1. 2021 MPFS proposed rule

   Overview of proposed physician fee schedule changes for the upcoming calendar year, including coding and payment policy topics affecting professional services.

2. E/M update: Coding and payment changes

   Discussion of proposed revisions affecting evaluation and management office visit coding, documentation, and valuation under the physician fee schedule.

3. New CPT codes

   Summary of proposed additions to the CPT code set across several service areas and specialties.

4. 2021 OPPS proposed rule

   Overview of proposed outpatient prospective payment system policies for the upcoming calendar year, including payment methodology topics and public comment areas.

5. Elimination of the IPO list

   Discussion of CMS’s proposed phased approach to changes affecting the inpatient-only list and related outpatient payment considerations.

6. 340B drug payments

   Summary of proposed outpatient drug payment policy changes related to the 340B program and alternative reimbursement approaches.