2021 EM CODES

[nbiernac@physiciansmgmt.com]

Has anyone found information on whether the EM Codes are going to change in 2021. I have providers trying to figure out what they are going to do if this happens when they have not recovered from the COVID-19 restrictions on their businesses.

 

[AmandaBriggs]

The codes themselves are not going to change, with the exception of 99201 which will no longer be an active code. The changes involve the guidelines used to select the level of service. Here's a link to an article by the AMA that discusses the changes:
https://www.ama-assn.org/practice-m...your-house-practice-checklist-2021-transition

 

[erjones147]

Is CMS still planning to pay levels 2, 3, and 4 at the same rate in 2021? Have not heard anything on this in a while.

 

[AmandaBriggs]

From what I've read, CMS is keeping the payment structure the same for 2021 as it is now.

 

[dorinda05]

Is CMS still planning to pay levels 2, 3, and 4 at the same rate in 2021? Have not heard anything on this in a while.

The rates will change as they do every year.
I’m in Florida and there is actually a webinar tomorrow on the 2021 E/M changes. I can’t remember who is hosting it but if you’re interested, please email @ dtillquist@bcmedsvcs.com tomorrow morning and I will forward you the link.

 

[jhendrix08]

Is CMS still planning to pay levels 2, 3, and 4 at the same rate in 2021? Have not heard anything on this in a while.

I agree with Amanda. I've come across a few articles that have made it sound as if those changes won't be taking place in 2021 as initially thought.

 

[Cynthia Hughes]

I am late in seeing and responding to this post but if anyone still needs information on this topic, the AMA has some good resources for understanding the changes planned for reporting office and other outpatient E/M services in 2021 (not CMS' earlier proposal for blended rates) at https://www.ama-assn.org/practice-management/cpt/cpt-evaluation-and-management and https://www.ama-assn.org/practice-m...ng-cpt-evaluation-and-management-em-revisions. One key piece of information is that the guidelines for office and other outpatient E/M services will be different from those for all of the other E/M services. So for 2021, keep with the CPT, 1995 or 1997 guidelines for services such as consultation, hospital care, etc. However, the simpler code selection for the office E/M codes should be welcome as practices continue dealing with the impacts of COVID-19. CMS has stated the CPT changes for office E/M will be accepted for 2021 and also proposed a G code to provide increased payment to physicians who primarily provide E/M services in 2021. Watch for more from CMS when the proposed rule for the 2021 Medicare Physician Fee Schedule is published (probably soon).

I hope that is helpful.
Cindy

 

[Gator]

I found this to be very helpful. https://www.asco.org/practice-polic...ion/prepare-2021-em-code-changes-free-webinar