MPFS final rule: 2021 conversion factor gets 10% squeeze, E/M revisions remain on track

Why This Topic Matters

The final rule affects Medicare reimbursement, service selection, and telehealth availability across many physician specialties. It is relevant for organizations that code office visits, manage outpatient documentation workflows, or track fee schedule and telehealth policy changes.

Article Sections

1. CF cuts balance E/M gains

   Discusses the overall Medicare fee schedule impact for 2021, including payment changes tied to office and outpatient E/M services and specialty-level reimbursement effects.

2. E/M documentation changes on track

   Summarizes the status of office/outpatient E/M documentation and level-selection guidance for 2021, including the general approach to selecting visit levels.

3. CMS replaces prolonged service CPT code 99417

   Covers the prolonged visit add-on service policy discussion and the related disagreement between CPT and HCPCS reporting approaches.

4. Visit complexity add-on code arrives

   Addresses the new add-on service associated with complex office/outpatient visits and CMS’s rollout of that guidance.

5. Telehealth rules under COVID-19

   Reviews telehealth policy changes for the public health emergency period, including additions to the Medicare Telehealth List and category-based extensions.

6. Telephone visits get a new interim G code

   Explains the temporary payment policy for brief communication technology-based services after the public health emergency and how it fits alongside telephone visit policy.