Skip Navigation LinksHome | Editors' Blog
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.
Medicare issued an update to its COVID-19 fact sheet May 27, and it contains more answers your telehealth documentation and coding questions.The topics relevant to Part B billing range from modifier use to how to report a telehealth encounter if the practitioner or the patient experience technical difficulties.
The big pay boost for telephone E/M codes performed by physicians and qualified health care professionals (99441-99443) is good news for practices that have performed audio-only telephone encounters during the COVID-19 emergency.
In addition, the update should remind practices to make sure they know when they can report an office E/M telehealth visit and determine if their state’s Medicaid program will reimburse the practice for audio-only encounters.
A phone call with a patient — plus complete documentation — will be all it takes to report 89 services on Medicare's telehealth list. Practices will also be able to receive full reimbursement for 39 new services performed via telehealth, according to the updated telehealth list posted today. The changes are retroactive to March 1.
CMS and private payers have knocked down barriers for telehealth and telemedicine services during the COVID-19 public health emergency (PHE). But a MedPage Today article reveals that barriers to payment remain, and the steady flow of changes to coding and billing guidance is a major hurdle.


User Name:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Blog Archive
Back to top