The 2020 Medicare Physician Fee Schedule Final Rule unpublished version released Nov 4, 2019, confirms that the E/M code changes take effect in 2021. Changes to E/M services will be significant — although the changes won’t take effect until 2021:
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CPT E/M Code Changes Confirmed
CPT E/M Code Changes Confirmed
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 that bill lower-level codes or fewer E/M codes overall (those practices are more likely to see a decrease in overall payments).
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