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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. 
 
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.
 
Here’s a good reason not to rely on CMS and the physician fee schedule for your CPT coding advice: The agency appears to be a bit confused about how to use the new musculoskeletal add-on codes for drug delivery device implant and removal.
 
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.
 
 
The groundbreaking E/M code changes that are on track to arrive by 2021 gained clarity after the AMA released a preview of the E/M documentation guidelines you’ll use to code office visits in 2021.
 

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