Part B News | Editors' Blog

Breaking: CMS proposes 11% cut to 2021 conversion factor, confirms E/M coding overhaul

by: DecisionHealth Staff Aug 4, 2020

You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released this morning. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.

Influencing the substantial decrease to the CF are the projected pay increases to the core set of E/M office visit codes (99202-99215). CMS confirmed that the E/M office visit codes remain on track for their first major overhaul in 25 years, according to the proposed 2021 Medicare physician fee schedule.

Trading jabs: CMS changes coverage status for dry needling, acupuncture

by: Julia Kyles, CPC Feb 14, 2020

If the news that Medicare will cover acupuncture for chronic low back pain piqued your interest, review the guidelines for dry needling and acupuncture codes.

E/M-driven redistribution draws scrutiny at AMA Symposium

by: Richard Scott Nov 20, 2019

CHICAGO, Nov. 20 - After several sessions covering the historic E/M code changes moving closer to reality, some audience members here at the CPT and RBRVS 2020 Annual Symposium had pointed questions for CMS officials about the billions of dollars potentially on the move under the physician fee schedule in 2021.

CMS bumps fees for CMS, elevates TCM

by: Julia Kyles, CPC Nov 6, 2019

CMS scaled back many of the proposed changes to chronic and transitional care management services (CMS), but a few made it to the final rule. Next year you’ll have an add-on code for chronic care management code provided by clinical staff and two codes for management of a single high-risk condition.

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.

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