General Surgery Coding Alert - 2019 Issue 22
E/M Coding: Feds Follow Through on E/M Revamp
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Article Overview
This article explains how CMS finalized major changes to office/outpatient evaluation and management services in the CY 2020 Medicare Physician Fee Schedule, with an implementation date in 2021. It is relevant to coding professionals, compliance staff, practice managers, and clinicians who track documentation, valuation, and payment policy updates for E/M services. The discussion covers CMS and AMA collaboration, documentation and time-related revisions, code-level updates, add-on code planning, RVU valuation changes, and the potential impact on different specialties.
Why This Topic Matters
The article highlights policy changes that affect how office/outpatient E/M services are documented, valued, and paid. It helps readers understand which parts of the E/M update were finalized, the timing of the transition, and why some practices may see payment shifts.
Article Sections
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Background
Introduces the CMS final rule context and summarizes the broader Medicare fee schedule update environment.
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Here Are the E/M Specifics
Outlines the main categories of finalized E/M office/outpatient changes and the implementation timeline.
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Some Specialties May See E/M Pay Cut with New RVUs
Discusses valuation updates, specialty-level payment implications, and CMS’s response to public comments.
What You Will Learn
- How CMS framed the final E/M policy changes in the Medicare physician fee schedule
- Which broad documentation and valuation topics were revised for office/outpatient E/M services
- How the article characterizes the planned 2021 rollout and potential practice impacts
- Why the payment effects may differ across specialties
Who Should Read This
- Medical coders
- Billing and reimbursement professionals
- Compliance staff
- Practice managers
- Physicians and clinical documentation teams
- Health policy readers
Codes Discussed
Code Ranges Discussed
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