Outpatient Facility Coding Alert - 2019 Issue 12
News You Can Use: Know What the PFS Has in Store for You in 2020
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Article Overview
This article explains selected changes in the 2020 Medicare Physician Fee Schedule final rule that are relevant to evaluation and management coders, care management reporting, and prolonged service coding. It is aimed at coding professionals, billing staff, and practices that need to understand which policy updates begin in 2020 and which E/M changes are scheduled for 2021. The discussion covers the introduction of principal care management, updates tied to chronic and transitional care management, and the shift toward revised outpatient E/M reporting.
Why This Topic Matters
These policy updates affect how practices plan for Medicare reporting changes, update workflows, and prepare for upcoming E/M revisions. The article helps readers understand the scope of the changes and where coding and documentation processes may need attention.
Article Sections
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First, the Good News
This section discusses the general Medicare Physician Fee Schedule update for 2020 and the broader context for the rule changes.
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What Happens Next Year?
This section covers the new principal care management topic, related care management updates, and the timing of those changes.
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The E/M Overhaul Countdown Begins
This section reviews the upcoming evaluation and management changes, including Medicare alignment with revised outpatient visit reporting and the planned transition away from certain prolonged service reporting.
What You Will Learn
- How the 2020 Physician Fee Schedule affects coding and reimbursement planning
- What principal care management is intended to address at a high level
- Which care management areas are being updated alongside the new reporting framework
- What major E/M policy changes are scheduled for 2021
- How prolonged service reporting is changing under the revised approach
Who Should Read This
- Medical coders
- Billing staff
- Physician practices
- Compliance teams
- Revenue cycle professionals
Codes Discussed
Code Ranges Discussed
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