CMS Makes Changes to Medicare Physician Fee Schedule Rates
Friday, January 15th, 2021

CMS updated the 2021 Medicare Physician Fee Schedule prices after a COVID-19 stability bill relaxed budget neutrality cuts finalized in a rule introduced last month.

The 2021 Consolidated Appropriations Act, enacted by Congress in December, enacted a 3.75 percent rise in Medical Care Plan payments for all hospitals in 2021 to support physicians and other professionals in adjusting to changes in reimbursement for physician services this year.

Payments for the Healthcare Common Practice Coding System (HCPCS) code G2211 were then placed on hold by the $1.4 trillion COVID-19 stimulus bill for a three-year period, which also impacted the budget neutrality provision in the Physician Fee Schedule. G2211, an add-on code for the difficulties inherent in appraisal and administration visits, comprised nearly $3 billion, or three percent, of investment on the Medicare Provider Fee Schedule.

The delay in the implementation of the code would assuage the budget neutrality adjustment, and as a result, some clinicians will no longer face dramatic rate increases, as detailed in the 2021 Medicare Physician Fee Schedule final rule.

In the final rule, CMS decided to increase premiums for assessment and management services that promote chronic illness primary care and treatment, which prompted the budget-neutrality adjustment factor for 2021.

To read more, please visit https://revcycleintelligence.com/news/cms-recalculates-medicare-physician-fee-schedule-rates-for-2021.

This update is provided by CareOptimize. We provide healthcare management consulting services and products, managed care solutions, value-based expertise, Nextgen EHR utilities, MIPS consulting, and more. CareOptimize has helped numerous healthcare organizations succeed for more than a decade. For more information, please call 855.937.8475.