Medicare Impact of proposed E&M Guideline changes

CMS has delayed the consolidation of services until 2021.
The 2019 E&M changes are very modest, but most practices will have some financial and RVU impact.
To see how the new RVUs and conversion factor will impact your providers, either:
  1. Enter the number of times you expect to perform each service.
  2. Enter their NPI code in the field below, which will give you a head start by looking up the latest data available to us (2016).
The calculations use the difference between the 2018 and 2019 RVU values and your office visit procedure counts.


Year:    NPI to research: 

Interpretation Guide

For each procedure code, there are five columns:
  1. Total RVU Delta – This takes the difference between the 2019 and 2018 non-facility Total RVU. Here, we subtract 2018 from 2019.
  2. Financial Delta – This column involves several calculations. First, we multiply the count times the total RVU for both 2018 and 2019. Then, we multiply the respective total RVU values times the respective conversion factors. The next step is to subtract the 2018 allowed from the 2019 allowed. This gives us the best estimate for the financial difference.
  3. Financial Impact – Here, we divide the financial delta by the 2018 allowed amount based on the counts you report in the Total Count field. The purpose here is to calculate what the percent change will be moving from 2018 to the proposed 2019 model.
  4. Work RVU Delta – This is simply the difference between the 2018 and 2019 work RVUs times the Total Count. Spoiler, the Work RVUs did not change!
  5. Work RVU Impact – For this column, we take the Work RVU Delta and divide it by the total Work RVU for 2018 (based on the values in the Total Count column).