Episode 8: Major Payment and Documentation Changes Coming in 2021

The Centers for Medicare and Medicaid Services (CMS) finalized a proposal to streamline documentation requirements and increase payments for E/M office visits beginning in January 1, 2021.

Starting January 1, 2021, physicians can expect to see: 

• Separate payment for 4 levels of E/M visit codes for new patients 

• Deletion of Level 1 code for new patients, which is generally not performed by a physician. 

• Separate payment for 5 levels of E/M visit codes for established patients. 

• Adoption of new CPT code descriptors.

• Elimination of the use of history and/or physical exam to select among code levels for payment. Physicians must still document clinically relevant history and physical exams.  

• Physicians can now choose to use either time or Medical Decision Making (MDM) to justify the level of E/M service.

Have feedback or suggestions for future topics? Email us at:
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Additional links:

Have a coding question? Submit a ticket into ACOG's FreshDesk Ticket Database:
https://www.acog.org/About-ACOG/ACOG-Departments/Coding/New-Ticket-Database-for-Coding-Questions 

Practice Management Ticket Database:
https://www.acog.org/About-ACOG/ACOG-Departments/ACOG-Practice-Management-Ticket-Database 

Additional links to coding resources:
https://www.acog.org/About-ACOG/ACOG-Departments/Coding 

ACOG Legal Disclaimer:
Information contained in this podcast should not be construed as legal advice. As always, practitioners should consult their personal attorney about legal requirements in their jurisdiction and for legal advice on a particular matter. The information presented in this podcast is for guidance purposes only. ACOG makes no representations and/or warranties, express or implied, regarding the accuracy of the information contained in this podcast. ACOG assumes no liability for any consequences resulting from or otherwise related to any use of, or reliance on, this podcast. Inclusion of any product, procedure, or method of practice in this presentation does not constitute endorsement by the College.

Music Attribution:
Our intro and outro music is a derivative of “Golden Sunrise (Instrumental Version)” from the album The Wake by Josh Woodward, used under a Creative Commons Attribution 4.0 International License
Free Download: https://www.joshwoodward.com/
Album: The Wake
Creative Commons Attribution 4.0 International License