E/M Coding: Feds Follow Through on E/M Revamp

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

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

  1. Background

    Introduces the CMS final rule context and summarizes the broader Medicare fee schedule update environment.

  2. Here Are the E/M Specifics

    Outlines the main categories of finalized E/M office/outpatient changes and the implementation timeline.

  3. 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

  • CPT: 99211
  • CPT: 99215
  • CPT: 99201
  • CPT: 99202
  • CPT: 99203
  • CPT: 99204
  • CPT: 99205

Code Ranges Discussed

  • CPT: 99211-99215
  • CPT: 99202-99205

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