For example, the original relative value file assigned a total of 3.81 non-facility RVUs to established patient office visit code 99214. That works out to $132.94 without locality adjustments when multiplied by $34.8931 the new conversion factor.
The revised file gives the code 3.76 RVUs with a resulting $131.20 payment. The loss of $1.74 for a single encounter might go unnoted but could add up to a significant shortfall at the end of the year.
Check the chart below for the impact on the office visit codes and be aware that CMS made changes to more than 3,000 E/M and procedure codes. To be safe,
use the new file to recalculate.
|
Code
|
Short descriptor
|
Revised 2021 RVU
|
Original 2021 RVU
|
% RVU difference
|
Revised 2021 $
|
Original 2021 $
|
Change to $
|
|
99202
|
Office o/p new sf 15-29 min
|
2.12
|
2.13
|
-0.47%
|
$73.97
|
$74.32
|
-$0.35
|
|
99203
|
Office o/p new low 30-44 min
|
3.26
|
3.28
|
-0.61%
|
$113.75
|
$114.45
|
-$0.70
|
|
99204
|
Office o/p new mod 45-59 min
|
4.87
|
4.93
|
-1.22%
|
$169.93
|
$172.02
|
-$2.09
|
|
99205
|
Office o/p new hi 60-74 min
|
6.43
|
6.51
|
-1.23%
|
$224.36
|
$227.15
|
-$2.79
|
|
99211
|
Office o/p est minimal prob
|
0.66
|
0.68
|
-2.94%
|
$23.03
|
$23.73
|
-$0.70
|
|
99212
|
Office o/p est sf 10-19 min
|
1.63
|
1.67
|
-2.40%
|
$56.88
|
$58.27
|
-$1.40
|
|
99213
|
Office o/p est low 20-29 min
|
2.65
|
2.68
|
-1.12%
|
$92.47
|
$93.51
|
-$1.05
|
|
99214
|
Office o/p est mod 30-39 min
|
3.76
|
3.81
|
-1.31%
|
$131.20
|
$132.94
|
-$1.74
|
|
99215
|
Office o/p est hi 40-54 min
|
5.25
|
5.33
|
-1.50%
|
$183.19
|
$185.98
|
-$2.79
|