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CBIZ 2021 E/M Impact Analysis

By Adam Abramowtiz, Senior Manager, Marketing and Sales

Physician office E/M reimbursement will be impacted by the new CMS regulations scheduled to go into effect in 2021.  Here are some highlights of the proposed changes:

  • Changes will impact existing E/M codes 99201 to 99215 – with 99201 being eliminated.
  • History and physical exam will no longer be counted as key components of the visit level.
  • Medical Decision Making (MDM) and time spent with the patient will now be the key drivers for assignment of visit levels.
  • There will be new add-on reimbursement codes for primary care physicians and specific long-duration office visits.

CBIZ KA Consulting Services, LLC (CBIZ) will be modeling the 2021 E/M reimbursement changes and we are looking for a few hospitals to help us refine our revenue impact model.  With new drivers now determining physician office visit reimbursement, your practices may face significant changes in expected revenue once the new regulations go into effect.

CBIZ wants to help our clients stay ahead of the curve by making accurate projections for their future E/M revenue.  Our models will present a range of scenarios based on anticipated volume trends and the utilization of E/M codes that will be affected by the new regulations.

During the beta test phase of our E/M modeling, CBIZ is offering participating hospitals a complimentary analysis of their projected E/M revenue using the 2021 regulations.  

Here are the data elements for the analysis:

Data Requirements:

  • Volume by visit level
    • New patient office visits
    • Established patient office visits
  • Expected number of prolonged services, as percent of current E/M level 5 (codes 99205, 99215)
    • Number of visits with more than 75 minutes per new patient
    • Number of visits for more than 55 minutes per established patient
  • Percentage of primary care visits

Click here to sign up or if would like additional information, please contact Adam Abramowitz at 609-918-2093 or aabramowitz@cbiz.com.

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