Industry Update: CMS Delays Changes to E/M Codes

On Nov. 1, 2018, the Centers for Medicare & Medicaid Services (CMS) announced its final 2019 Physician Fee Schedule. The healthcare industry news includes a delay in a proposal that would have blended payments for new and established patients for office/outpatient E/M levels 2 through 5 into single payments. Instead, the agency will continue to hear perspective on the proposal with plans to collapse E/M code levels 2 through 4 into single payments beginning in 2021, while maintaining level 5.

At this time, no changes will be made to the E/M code set. However, several physician groups and associations, including the American Medical Association, have motioned to make recommendations to CMS on the future code changes. It is stated that physicians can engage with CMS to discuss refining the final policies for 2021.

It is advised that healthcare providers use the next two years to determine how the E/M changes could impact their physicians, patients, and bottom line, particularly for the proposed changes. In this industry update document, Guidehouse shares vital information on this announcement and how these changes could impact your organization. Guidehouse offers professionals who can provide insight on how to plan and mitigate for the potential impact. 

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