News You Can Use: Evaluate CMS’ Proposed PFS, Manage Your 2021 E/M Expectations

Why This Topic Matters

The proposal could affect payment levels, service availability on telehealth lists, and how certain prolonged service reporting is aligned with CMS versus CPT guidance. Readers who work with Medicare outpatient coding or physician reimbursement need to know what is being proposed and where CMS may differ from existing CPT expectations.

Article Sections

1. Payment Increases Planned for Some E/Ms, Immunization Administrations …

   Discusses proposed payment changes affecting selected evaluation and management services and related Medicare reimbursement categories. It also places those changes in the context of the larger physician payment update.

2. … While CF May Be Going Down

   Explains the proposed movement in the conversion factor and why that part of the rule is drawing attention from physician organizations. The section frames the broader payment implications without going into service-level selection details.

3. Telehealth Expansion Continues Apace …

   Covers proposed additions to the Medicare telehealth list and the related request for comments on further telehealth expansion. The focus is on the scope of services under consideration rather than final policy outcomes.

4. … While the Prolonged Service Proposal is Perplexing

   Addresses CMS’ proposed treatment of prolonged office/outpatient evaluation and management reporting and its relationship to existing CPT guidance. It highlights the issue at a high level and notes that the two frameworks may not align.