Grassi Healthcare | Compliance Alert: CMS Postpones proposed changes to Evaluation and Management Services to 2021
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Compliance Alert: CMS Postpones proposed changes to Evaluation and Management Services to 2021

11/13/2018

CMS released the final Physician Fee Schedule (PFS) rule on November 1, 2018 and expects to publish it on November 23, 2018.  We have all been holding our breath to see what the outcome would be for many of the proposed changes, especially those for E/M services.  We personally felt like we were at the starting gate waiting for the bell to ring!

While there were  many major changes proposed for a multitude of services, one of the most anticipated changes, the one impacting Evaluation and Management services has been postponed until 2021.  According to the Federal Register CMS states;

“After considering the comments, especially those suggesting that implementation of significant payment and coding changes requires time for practitioners, vendors, health systems, and other stakeholders to prepare, we are finalizing modified changes in payment coding, and associated documentation rules for E/M office/outpatient visits for 2021”
 
So for now, Providers will continue the current coding and payment structure for E/M office/outpatient visits, which includes using either the 1995 or 1997 versions of the E/M guidelines to document E/M office/outpatient visits.

We recommend you take the extra time to get out ahead of these current and historic changes. All other final changes passed will become effective January 1, 2019. Here is the link to the Federal Register, final rule.
https://s3.amazonaws.com/publicinspection.federalregister.gov/2018-24170.pdf

We all know how change, good or bad tends to open the door to new risks, especially if we are not prepared, and if processes are not implemented correctly. Please reach out to us if you have questions, or want help with implementation of final changes or assistance with planning and preparing for the future.