CMS 2019 Updates You Need to Know

CMS is finalizing a number of documentation, coding, and payment changes to reduce administrative burden and improve payment accuracy for office/outpatient evaluation and management (E/M) visits over several years. For calendar years (CY) 2019 and 2020, CMS is implementing several documentation policies to provide immediate burden reduction, while other changes to documentation, coding, and payment would be implemented in CY 2021.

For CY 2019 and CY 2020, CMS will continue the current coding and payment structure for E/M office/outpatient visits, and practitioners should continue to use either the 1995 or 1997 E/M documentation guidelines to document E/M office/outpatient visits billed to Medicare. For CY 2019 and beyond, CMS is working to finalize the following policies:

Beginning in CY 2021, CMS will further reduce burden with the implementation of payment, coding, and other documentation changes. Payment for E/M office/outpatient visits will be simplified and payment would vary primarily based on diagnosis that do not require separate, complex documentation.
Specifically for CY 2021, CMS is finalizing the following policies:

Need assistance with your practice? Contact Billie Jean Davenport, Director of Practice Management, at with any questions.