Part B News | Editors' Blog

Breaking: 2020 fee schedule confirms E/M overhaul, updated rates, new codes and more

by: DecisionHealth Staff Nov 1, 2019

The vast reshaping of E/M documentation standards and payment changes took a significant step closer to reality as CMS put a stamp of approval on its previous proposals to overhaul how medical practices report office and outpatient E/M services 2021.

Next year many providers will see a modest boost to the conversion factor that, along with relative value units (RVUs), dictates pay rates across all services in the Medicare physician fee schedule. The conversion factor will rise to $36.0896 in 2020, which CMS previously proposed, from $36.0391 in 2019, according to the final fee schedule. However, the anesthesia conversion factor will decrease to $22.2016 in 2020 from $22.2730 this year. That’s a drop from the proposed anesthesia conversion factor of $22.2774.

Billions at stake: How big pay gains for E/M codes could upend the fee schedule

by: Richard Scott Aug 22, 2019

You've heard by now of the momentous changes coming to your office-based E/M codes in 2021. And perhaps you caught wind of accompanying payment updates. But just how game-changing are the new payments?

RUC proposes, CMS disposes and the difference could mean a lot of dollars to doctors

by: Julia Kyles, CPC Aug 12, 2019

CMS has painful plans for the somatic nerve block family of codes next year. Proposed cuts to work and other relative value units (RVUs) will result in lower pay for most codes in the 64400-64450 range, DecisionHealth analysis of the proposed 2020 Medicare physician fee schedule reveals.

Breaking: CMS backtracks on E/M pay changes, pivots to documentation overhaul

by: DecisionHealth Staff Jul 29, 2019

You can dismiss a lot of the controversial updates to office E/M services, such as blended payment rates, that drew an outcry from the medical community. But you’re now on the clock to get in line with far-reaching documentation changes for these oft-used services, according to the 2020 proposed Medicare physician fee schedule released today.

CMS revises fees for 822 codes, you’ll have to tell your MAC if it owes you money

by: Julia Kyles, CPC May 3, 2019

The good news: You may be due for additional reimbursement retroactive to Jan. 1. The merely OK news: You’ll have to check your claims and ask your Medicare administrative contractor (MAC) for an adjustment. The not great but could be worse news: You may owe your MAC money on some claims, but it’s just a few cents per claim.

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