Wiki Medicare Payment Model Changing 2021?

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kstine713

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Hello!

I know there has been a proposed change to the CMS payment model for E&Ms. See link: https://www.aapc.com/blog/45545-changes-ahead-for-cms-e-m-requirements-and-reimbursement/

Does anyone know if this change is going to be effective January 1, 2021? Or are the only changes the guidelines for choosing your level of E&M service? We are prepared for that change, but may need to prepare financially for the above mentioned change if 99202-99204 will all be paid at the same rate and 99212-99214 will all be paid at the same rate. I can see this change making it hard to convince our providers to care about their coding, but maybe that's my skepticism coming out.

Any sources you can provide would be much appreciated!

Thank you!
Kaytie
 
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As I understand it, CMS has stated that it will not implement the payment model described in the article you cited in the link (i.e. they will not make the payment identical for E&M levels 2, 3 and 4). There will, however, be adjustments in the rates paid for office/outpatient E&M codes to update and align payment with the changes going into place. The final rule on the fee schedule has not been issued yet, so all of this is still technically just 'proposed'.

The final version of the guidance and payment changes should be issued within the next two weeks or so and you can look for it to appear here:

 
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