CMS 2021 Proposed Physician Fee Schedule Rules, Simplified

We just got done reading all 1,353 pages of CMS’s 2021 Proposed Rule. And wow, was that a doozie.

Every year, the Office of the Federal Register (OFR) releases CMS’s Proposed Rules, and they’re always a fascinating read - even when we’re not in the middle of a public health emergency. The reason we do so is to look through the proposed rule and find what changes will impact our coding, auditing, compliance, or billing responsibilities when the new year begins. We also read it because now is the time for interested parties to make known their thoughts about the items within the Proposed Rules.

Per the OFR:

“The proposed rule, or Notice of Proposed Rulemaking (NPRM), is the official document that announces and explains the agency’s plan to address a problem or accomplish a goal. All proposed rules must be published in the Federal Register to notify the public and to give them an opportunity to submit comments. The proposed rule and the public comments received on it form the basis of the final rule.” (You can read the full document here.)

But with that much content to dive through, atop all of the other projects currently on your plate, we know it’s a lot to ask for most people to read, let alone comment on.

That’s why every year, we look to the proposed rule to see what changes will impact our coding, auditing, compliance, or billing responsibilities when the new year begins. After combing through all (yes, all) 1,353 pages of the 2021 Proposed Rule changes, we settled on three topics to distill for you:

1. Evaluation & Management
2. Telehealth
3. Teaching Physician Rules

The reason for settling on these three is because they are the most common areas we here at Healthcity work within, and are most commonly asked about from clients and the broader community. And, because we field so many questions, we’ve boiled all the new updates down into a digestible and actionable new eGuide we’re calling, “Highlights from the CMS 2021 Proposed Physician Fee Schedule Rules.” Inside, we covered the above topics enabling you to:

• Transition to the New E/M Framework
• Adapt to the Permanent and Temporary Telehealth Service Proposals
• Understand the Interim Teaching Physician Rules Policies

We recommend that where your practice may be impacted, you take the time to review the entirety of the upcoming changes. And remember to submit any relevant comments you believe should be considered as the OFR moves toward their final rule.

And when in doubt, feel free to reach out to us for your auditing needs. There’s nothing more that we love to do than help solve the challenges you face.