Question:

What are some of the specific policies CMS is finalizing for office/outpatient evaluation and management (E/M) visits in the year 2021?

Answer:

For the year 2021, CMS is working to finalize policies such as:

  • Reducing the payment variation for E/M office/outpatient visit levels by paying a single rate for E/M office/outpatient visit levels 2 through 4 for established and new patients while maintaining the payment rate for E/M office/outpatient visit level 5 in order to better account for the care and needs of complex patients
  • Permitting practitioners to choose to document E/M office/outpatient level 2 through 5 visits using medical decision-making or time instead of applying the current 1995 or 1997 E/M documentation guidelines, or alternatively practitioners could continue using the current framework.

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