E/M Coding Alert - 2021 Issue 2
Final Rule: Prepare Your General Surgery Practice for Big Medicare Pay Decrease
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Article Overview
This article explains the 2021 Medicare Physician Fee Schedule final rule as it relates to general surgery reimbursement. It focuses on the conversion factor change, related legislative updates, and the expected effect on surgery-heavy practices versus office/outpatient E/M services. The piece is aimed at surgeons, coders, billing professionals, and practice managers who need a high-level understanding of Medicare payment policy changes and their operational impact.
Why This Topic Matters
Medicare payment policy changes can materially affect surgical practice revenue, staffing, and budgeting. This article helps readers gauge the likely direction of payment changes and understand the broader policy context behind them.
Article Sections
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Drill Down to CF Impact
This section reviews the 2021 Medicare payment update and the conversion factor change, along with the policy context behind the adjustment. It also discusses the associated legislative and CMS follow-up updates at a high level.
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Focus on Surgical Practice Pay
This section examines how the payment changes may affect surgery-focused practices and compares the expected effects across different service mix patterns. It also addresses the broader implications for general surgery reimbursement in 2021.
What You Will Learn
- The policy changes described in the 2021 Medicare Physician Fee Schedule final rule
- How conversion factor changes can affect surgical practice reimbursement
- Why office/outpatient E/M updates are relevant to surgeons
- How broader Medicare payment updates may influence different practice service mixes
- What types of stakeholders are responding to the reimbursement changes
Who Should Read This
- General surgeons
- Surgical practice managers
- Medical coders
- Billing and revenue cycle staff
- Healthcare compliance professionals
- Practice administrators
Codes Discussed
Code Ranges Discussed
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