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Medicare and Compliance Changes: 2021 *


The Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (PFS) rule for 2021. Will they impact your reimbursement? Yes! Every specialty that bills Medicare for services rendered will feel the squeeze next year!

CMS is implementing the biggest changes in decades to Evaluation and Management documentation guidelines, coding, and reimbursement on January 1. One of the most impactful proposals on the table is the downward adjustment in the conversion factor ($3.83 reduction from $36.09 in 2020). Medicare payments for the following services may also be reduced: -9% for cardiac surgery, -8% for thoracic surgery, -7% for vascular surgery, -7% for general surgery, -7% for neurosurgery, and -6% for ophthalmology compared with 2020 rates.

Course Highlights

  • Payment for office/outpatient E/M and Analogous visits
  • Important key points of several proposals regarding the professional scope of practice and related issues such as supervision of diagnostic tests by certain NPPs, pharmacists providing services incident to the physician services, medical record documentation for physician and NPPs, and more
  • Initial Preventive Physical Examination and Annual Wellness Visit to include screening for potential substance use disorders
  • Medicare coverage for opioid use disorder treatment services
  • Principal care management services in Rural Health Clinics and Federally Qualified Health Clinics
  • Electronic prescribing of Schedule II, III, IV, or V controlled substance under Medicare Part D
  • 2 new HCPCS codes, G2064 and G2065, to the general care management HCPCS code, G0511, for PCM services furnished in RHCs and FQHCs
  • Removal of outdated National Coverage Determinations
  • CMS has also announced a series of standard technical proposals for 2021. Find out which proposals could have a positive or a negative effect on your practice, as well as on your patients.
  • Telehealth temporary category of reimbursements during the public health emergency will expire; no extensions have been announced. However, a temporary category of reimbursements tied directly to the current COVID-19 pandemic remains in place as of this writing.

Full Schedule


Program times are Central unless otherwise noted.

Date TimeFee Instructor
Two sessions:
12/4 and 12/11
12:00-01:30$199Linda D'SpainRegister
December 04, 202012:00-01:30$199Linda D'SpainRegister
December 08, 202009:00-12:00$199Jan HaileyRegister
December 10, 202008:00-11:00$199Jan HaileyRegister
January 13, 202109:00-12:00$199Register

CEUs:

PMI 3
AAPC 3

Target audience: This is an intermediate-level course designed for medical office coders, billers, auditors, clinicians, and practice managers.


*This program has the prior approval of AAPC for 3 continuing education hours valid through 11/30/21. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.
AAPC Medical Coding CEU Approved Vendor