The MPFS Final Rule: What You Need to Know

At the change of each calendar year, those of us in medical coding and billing have to review the Medicare Physician Fee Schedule (MPFS) and ensure we report our services correctly. But as most of us already knew, this year we’re faced with a complete overhaul of evaluation and management (E/M) codes representing Office and Other outpatient services.

While it might be hard to believe, these definitions and protocols we’re leaving behind have served us for nearly 30 years! Sure, many of us have been hoping for an overhaul like this for a long time, but that doesn’t mean the burden these changes created didn’t add some undue stress to our already stressful professional lives. Ever since the proposed rule was originally published, around here we’ve been anticipating and debating the potential impact of the proposed changes to E/M documentation requirements and payment structure.

But now, the wait is over. And with the start of 2021 now officially upon us, it’s time to update our old processes and comply with the new expectations. Sounds a bit daunting, coming off an extended holiday, doesn’t it? Well, rest assured we, your community of fellow coders and auditors here at Healthicity are here to help.

Two of your favorite experts, Marina Gregory, Director of Audit Services, and Charla Prillaman, our Regional Vice President, have created a new eBrief just for you, “Highlights from the 2021 Physician Fee Schedule Final Rule,” where they analyze and explain the changes in this easy-to-digest thought leadership download. So get our new eBrief and start navigating the changes that were just implemented, including:

• Add-on Code for Visit Complexity
• Audio-only E/M Visit Codes
• Supervision of Diagnostic Tests
• Teaching Physicians and Telehealth