The modifications to the 2021 Physician Fee Schedule will impact Work RVU values and reduce Medicare reimbursement rates.

Is your organization prepared?


SullivanCotter CPT Solutions

On December 1, 2020, the Centers for Medicare & Medicaid Services (CMS) finalized its 2021 Physician Fee Schedule changes to the Evaluation & Management (E&M) codes, as well as other outpatient equivalent visit codes for OB and ESRD, and corresponding work RVU values to recognize increased work effort for office visits. These changes will have material implications on professional services reimbursement and physician and advanced practice provider (APP) compensation going forward.

The health care industry has not seen broad work RVU changes of this magnitude in well over a decade, so it will be critical for organizations using productivity-based plans to understand the impact of these changes on payor reimbursement, reported physician and APP productivity levels, employed and independent physician compensation arrangements and budgets, and to identify potential fair market value and commercial reasonableness implications.

Learn more about the changes to the 2021 Physician Fee Schedule >

With our industry-leading advisory services and innovative cloud-based technology solutions, SullivanCotter can help you better understand, prepare for, and develop a response plan to address the impact of these changes.

Click to enlarge

Provider Performance Management Technology™

Provider Productivity Insights

  • Analyze impact of changes to CPT codes and work RVUs against annual CMS scale conversion
  • Load real-time data for ongoing review and analysis of work RVU productivity
  • Work RVU and CPT code level productivity reporting capabilities at the organizational and individual physician or APP level
  • Compare individual physician or APP work RVU productivity against any market-leading benchmarks survey

Benchmarks360™

Clinical CPT Manager

  • Analyze and compare your organization’s CPT coding distribution at the specialty level against national physician and APP benchmarks including work RVU and CPT level volumes
  • Visualize trends in annual coding profiles and benchmarking data
  • Model impact of volume and full-time equivalent changes
  • Leverage automation to remove data and reporting errors
  • Customize views of coding details for clearer insights and custom analyses

SullivanCotter’s CPT Advisory Services

  • Guidance on the changes and important considerations relative to 2021 planning and beyond
  • Market insight and perspective on how other organizations are addressing the changes
  • Assistance in assessing the anticipated impacts, including technology solutions available to help in that analysis
  • Help understanding and identifying the potential implications of fee schedule changes on current fair market value standards and processes
Download PDF

Benchmarks360™

Powered by SullivanCotter’s proprietary benchmarking information, Benchmarks360™ is a suite of intelligent, web-based products that enables health care organizations to analyze and visualize workforce compensation and clinical productivity.

Learn more and request a demo >


Provider Performance Management Technology™

An industry-first, cloud-based solution that enables provider engagement through transparent performance-based compensation administration, reporting and analytical capabilities.

Learn more and request a demo >


Address the impact of CPT code changes on compensation and productivity

Contact SullivanCotter

Related Resources

How Dayton Children’s Hospital Transformed Its Approach to Clinical Workforce Planning

Dayton Children's Hospital recently partnered with SullivanCotter to conduct a comprehensive Provider Needs Assessment. In this case study, we highlight how organizations can utilize clinical supply and demand data to develop a well-informed 'master plan' for recruitment and hiring decisions.

Read More

Succession Planning and the Role of a Dynamic Provider Needs Assessment

Health care organizations are under pressure to ensure proper staffing and continuity of care to support the communities they serve. In addition to determining the right number and type of clinicians, organizations must also monitor potential retirements and reductions in clinical productivity levels to help inform succession planning needs.

Read More

Forbes | The Labor Crisis is Derailing Health Care Transformation

Without a stable and engaged workforce, health care organizations are limited in their ability to truly transform. Learn more from SullivanCotter's President and CEO, Ted Chien, on how organizations can address the ongoing labor crisis.

Read More