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IDSA to Continue Efforts to Prevent Implementation of E/M Code Changes

IDSA will engage congressional stakeholders to prevent the Centers for Medicare and Medicaid Services (CMS) from implementing its final rule on changes to E/M codes announced Nov. 1.  Members are also encouraged to visit the IDSA Advocacy Action Center and let your congressional representatives know of the negative impact these changes will have on your practice. 

The changes that CMS will implement are summarized below:

  • For Calendar Year 2019, CMS is finalizing several policies that reduce documentation requirements for E/M visits. The specific policies can be found here.
  • In CY 2021, the following coding and payment changes will go into effect--CMS will create a single payment rate for levels 2-4 E/M outpatient visits and maintain separate payment rates for new and established patients for level 5 E/M office/outpatient visits to account for the most complex patients and visits.
  • In CY 2021, CMS will finalize payment rates for levels 2-4 visits using the weighted average of the current inputs (work RVUs, direct PE inputs, time and specialty mix) assigned to the individual codes, based on the most recent 5 years of utilization for each of the constituent codes.
  • A summary table of the E/M changes that will go into effect in CY 2021 can be found here.

For more information, read this discussion post in the MyIDSA community by IDSA Board member Dan McQuillen, MD, FIDSA, and follow future issues of IDSA News and the Daily News Bulletin.


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