The Centers for Medicare and Medicaid Services (CMS) released the final 2019 Medicare Physician Fee Schedule (PFS) rule. Initially, CMS proposed significant changes to the way evaluation and management (E/M) services would be documented and paid. The ACC heard your concerns, and in a major shift reflecting ACC Advocacy efforts, the potentially disruptive adjustments were altered and/or delayed until 2021 in the final rule. CMS did not finalize its proposal to apply a multiple-procedure payment reduction to separate E/M services furnished on the same day as a global procedure; however, the agency did finalize the following changes to streamline E/M documentation for 2019:

• Allowing the use of time as the governing factor for selecting the level of an E/M visit.
• Allowing clinicians to focus on documentation changes since the prior visit or relevant items that are unchanged rather than re-documenting information.
• Allowing the documentation of medical decision-making or time instead of the continued use of the 1995 or 1997 E/M guidelines.
• Allowing clinicians to review and verify some medical record information entered by staff or the beneficiary instead of re-entering it themselves.