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Does Medicare Fee Schedule Include E/M Changes for 2020?


Posted Dec 31, 2019
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All Blogs

Does Medicare Fee Schedule Include E/M Changes for 2020?

Posted December 31, 2019
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QUESTION: I’m pretty nervous about the significant changes to the Evaluation and Management (E/M) codes being made soon. The 2020 CMS Physician Fee Schedule goes into effect January 1, 2020, Does it contain the changes?

ANSWER: The 2020 Medicare Physician Fee Schedule Final Rule confirms that the E/M code changes completely take effect in 2021. Changes to E/M services will be significant. Although the changes won’t take effect until 2021, it is recommended that practices start taking action now (considering the extent of the modifications). Here is a quick breakdown of the changes to get you started:

  • For new patients, there will be four levels of E/M codes instead of five. The definitions for each code level will change accordingly, but are yet to be determined. For current patients, you’ll still have five levels of codes to choose from.
  • CMS will add a new add-on code (99XXX) to bill for prolonged E/M visits.
  • While RVUs for E/M codes will increase, those increases will be offset by reductions elsewhere (most likely in the conversion factor, which will affect payments for all services.). Changes to the physician fee schedule must be budget-neutral, meaning that when payment for some codes increases, others decrease.
  • If your practice often bills high level codes, you’ll likely see a larger increase in payments, as opposed to practices who bill lower level codes or fewer E/M codes overall (those practices are more likely to see a decrease in overall payments).

Relevant Event: Implementing the 2020 Medicare Physician Fee schedule changes accurately the first time is no easy task. But you don’t have to do it alone, coding expert and educator, Kim Huey, MJ, CHC, CPC, CCS-P, PCS, CPCO, COC, can help.

During her  online training, Kim will walk you through how to identify which of the 2020 Medicare Physician Fee Schedule changes will most impact your practice, and how you can incorporate them more quickly and easily to keep your reimbursement flowing.

Related Online Training and Resources

Meet Your Writer

Kim Huey
MJ, CHC, CPC, CCS-P, PCS, CPCO
KGG Coding and Reimbursement Consulting, LLC

Kim is an independent coding and reimbursement consultant, providing audit, training and oversight of coding and reimbursement functions for physicians. Kim completed three years of pre-medical education at the University of Alabama before she decided that she preferred the business side of medicine. She completed a Bachelor’s degree in Health Care Management and went on to obtain certification through the American Academy of Professional Coders and the American Health Information Management Association. Recognizing the important position of compliance in today’s world, she has also obtained certification as a Certified Healthcare Compliance Consultant and a Certified Healthcare Audit Professional. Kim is also an AHIMA-approved ICD-10-CM trainer and has recently earned a Master of Jurisprudence in Health Law. For over twenty-five years, Kim has worked with providers in virtually all specialties, from General Surgery to Obstetrics/Gynecology to Oncology to Internal Medicine and beyond. She has spoken at the national conference for numerous organizations.