2021 Medicare Part B Update

National Government Services (NGS)

James Bavoso, Manager, NGS Provider Outreach & Education

View this excellent presentation at:   HERE -     Learn about:


  • The 2021 Medicare Physician Fee Schedule, and how to navigate to it on the NGS website 
  • Changes in the E/M (Evaluation and Management) system
    • New clarifications:  Level of Medical Decision Making (MDM)
    • New options for selecting an E/M code:  MDM Level versus Total Time Spent
    • New “Prolonged Service” code (99212):  When and how to use it 
    • Services that lead to COVID-19 testing (there is no patient cost-sharing for these services)
      • Use of Modifier CS for these services

  • Services on Medicare’s “Telehealth Services” List (no reduction in payment)
    • Use of Modifier 95
    • Services permanently on the Telehealth Services List
      • Versus:  Services on the list during the Public Health Emergency only
      • Versus:  Services on the list throughout the Public Health Emergency year
    • Services allowing “audio only”

   Preventive services:  New quick-reference e-chart (MLN Educational Tool – ICN 006559)