2021 Evaluation and Management CPT Codes

Understanding the Impact on Physician Compensation

Every year, the pCenters for Medicare and Medicaid Services (CMS) conducts a comprehensive review of the Current Procedural Terminology (CPT) codes and the corresponding Work Relative Value Unit (wRVU) values to determine if changes are needed based on the time, skill, training and intensity necessary to perform the procedure.

As a result, CMS is proposing a significant overhaul of the Evaluation and Management (E&M) codes, which represent various types of face-to-face office or other outpatient visits for new or established patients, to be incorporated in January of 2021.

The majority of specialties utilize these E&M codes, and assessing the impact this may have on compensation and productivity is critical. In this article, SullivanCotter addresses the following topics to help organizations understand the significance of these changes and educate themselves during this transition:

  • CMS efforts to recognize increased work effort for office visits as well as a summary of the 2021 changes
  • The potential impact on physician and advanced practice provider productivity levels and compensation arrangements – especially wRVU production-based plans or salary-based plans with wRVU performance measures
  • Other variables that could influence the assessment of your organization’s productivity

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