E/M Coding: Finalized Changes for 2020 and 2021


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CMS has changes to evaluation management coding for 2020 and 2021. The 2020 changes are significant and include new services and expansion of existing services. The changes finalized for 2021 include major changes to the physician requirements for documentation related to evaluation management coding.

Why Should You Attend:

The changes for 2020 represent significant revenue opportunities for the majority of clinicians that see Medicare patients. CMS would like to expand the CCM and TCM programs as they have been proven to improve the quality of care and reduce overall cost. For some practices these programs may represent between two and 20% of their revenue.

The changes for 2021 will be more impactful as they will remove onerous documentation requirements and allow clinicians to focus on documenting what is needed for patient care. It will also improve the efficiency of documentation, require significant changes to electronic health records, and potentially create audit vulnerabilities if the guidelines are not adhered to closely.

CMS made significant changes to certain Medicare programs, including the Chronic Care Management (CCM) and Transitional Care Management (TCM) programs. CMS also approved a new program for specialists referred to as Principal Care Management. In addition, there were significant changes to Remote Patient Monitoring (RPM) requirements. These programs create new opportunities for primary care physicians and specialists. These will be reviewed in detail during the presentation.

CMS approved landmark changes to the evaluation and management coding requirements for outpatient encounters for 2021. Documentation in the history and physical components of the encounter note will no longer be required to determine the level of service. The level of service will be determined based solely on the level of complexity of the encounter or the total time spent managing the patient during a calendar day. This presentation will review in detail the new requirements. Practices will need to start preparing and training their staff to take full advantage of these changes.

Areas Covered in the Webinar:

  • CCM update
  • TCM update
  • PCM introduction
  • Traditional evaluation and management coding requirements
  • Updated requirements for complexity of medical decision-making
  • Updated requirements for using time to determine level of service
  • Impact of the 2021 outpatient encounter coding changes in clinician practices
  • Potential audit vulnerabilities associated with the transition to the new coding guidelines

Who Will Benefit:

  • Medicare eligible physicians and other clinicians
  • Health Information Management (HIM) professionals
  • Practice Administrators
  • Healthcare CMIOs
  • Healthcare COOs
  • Clinical staff members
  • Healthcare compliance professionals
  • Healthcare analytics professionals
  • Quality performance professionals

Free Materials:

  • Reference documents
  • Rule documents or guidance
  • Checklist
  • SOP template
  • Easy fill in forms
  • Articles
Webinar Events
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Get in touch

(315) 632-0735,
(315) 750-4379