ED Coding & Reimbursement Alert - 2020 Issue 1
Physician Fee Schedule: Countdown to E/M Overhaul
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Article Overview
This article reviews selected provisions from the Medicare Physician Fee Schedule final rule that affect evaluation and management services. It is aimed at physicians, coding professionals, and practice leaders who need to understand the timing of the E/M overhaul, the broad direction of Medicare policy changes, and how the final rule aligns with CPT-based outpatient E/M guidance.
Why This Topic Matters
The changes discussed affect outpatient visit coding, documentation approach, and Medicare payment policy. Understanding the final rule helps practices prepare for the transition and evaluate how the updated framework may affect workflow and reimbursement.
Article Sections
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Overview
Introduces the Medicare Physician Fee Schedule final rule and the timing of the upcoming evaluation and management changes.
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Reversal
Summarizes the change in CMS policy regarding the earlier proposal affecting outpatient E/M level payment structure.
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Enactment
Describes the remaining E/M-related policy changes in the final rule and the move toward alignment with CPT-based outpatient guidance.
What You Will Learn
- How the Medicare Physician Fee Schedule final rule relates to the E/M overhaul timeline
- Which broad E/M policy proposals were changed or retained in the final rule
- How the article frames the relationship between Medicare policy and CPT outpatient E/M guidance
- What types of coding and documentation updates practices should anticipate
Who Should Read This
- Physicians
- Medical coders
- Coding managers
- Practice administrators
- Reimbursement specialists
- Healthcare consultants
Codes Discussed
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