As a reminder, the new Evaluation & Management documentation and coding guidelines go into effect January 1, 2021. The new documentation guidelines allow for the E&M level of service to be based both on time (with newly clarified time requirements for each level) and/or medical decision making. Changes include the deletion of CPT 99211 and an increase to the Work RVU values for CPT’s 99203-99205 (new patients) and 99212-99215 (established patients).
Examples of RVU increases are: 99203 – up 12.6%; 99204 – up 7%; 99205 – up 10.4%; 99212 – up 45.8%; 99213 – up 34%; 99214 – up 28% and, 99215 – up 32.7%.
Due to the budget neutrality stipulation, to account for the changes in RVU’s (including significant increases for E&M codes), the final CMS 2021 Professional Fee Schedule (PFS) conversion factor is $32.41 (a decrease of $3.68 from the CY 2020 PFS of $36.09).
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