CMS News: AAFP Asks CMS for More Codes for Outpatient Settings

Why This Topic Matters

It matters because outpatient E/M coding is central to how office-based physician services are reported and paid under Medicare, and the article discusses a potential CMS review that could affect future fee schedule updates.

Article Sections

1. Outpatient E/M coding and Medicare payment context

   Introduces the policy concern about outpatient evaluation and management coding in the Medicare physician fee schedule and the broader shift in care delivery.

2. AAFP and other organizations ask CMS for changes

   Summarizes the physician organizations’ request for CMS to examine outpatient E/M coding and payment and to consider updated guidance based on current practice patterns.

3. Proposed study, timetable, and recommendations

   Describes the proposed contractor study process, the general timeline for meetings, data collection, and recommendations, and the intended schedule for possible implementation.

4. Scope of the proposed code set update

   Notes the request for a single outpatient E/M code set to apply broadly across physicians and other health professionals, along with participation from specialty groups.