CMS Finalizes CY2021 Medicare Physician Fee Schedule - Payment Cut to Physicians Imminent: TAKE ACTION NOW!

Yesterday, the Centers for Medicare and Medicaid Services (CMS) released the 2021 Medicare Physician Fee Schedule (PFS) final rule. In the rule, the Agency finalized a significant budget neutrality adjustment arising from previously finalized policy changes to office and outpatient evaluation and management (E/M) codes. The result is a CY2021 physician payment conversion factor of $32.41, a decrease of $3.68 from the CY2020 conversion factor of $36.09. This amounts to a 10.2 percent payment cut for some specialties. 
The massive payment reduction was finalized despite comments from every corner of the physician community, including from ASNC, asking CMS to use all authorities at its disposal, including the public health emergency, to waive budget neutrality or mitigate the severity of the cut. 

The 10.2 percent payment cut could not come at a worse time for physicians. Cardiologists will see a 1 percent increase on average in their Medicare payments next year; however, for those cardiologists who rely on imaging to diagnose and manage their patients, cuts will be significant.

Payment cuts will be layered on top of unreimbursed costs that physician practices will need to absorb to safely provide care throughout the pandemic as well as Medicare rates that have not kept pace with inflation. 

Meanwhile, congressional lawmakers are working to avert a federal government shutdown on Dec. 11. ASNC's advocacy team is urging Congress to intervene on behalf of physicians. Physicians also must make their voices heard to ensure they are not overlooked in Congress' next must-pass bill. 
PLEASE TAKE A MOMENT TODAY to email your members of Congress asking them to stop Medicare cuts to physicians.


ASNC's advocacy team is analyzing the final rule, but is pleased to report success on these key initiatives:  
  • CMS will continue contractor pricing for Myocardial PET in CY2021 (CPT codes 78432, 78459, 78491, and 78492), which will allow for payment predictability and continued patient access to this important imaging technology. 
  • CMS has removed the National Coverage Determination 220.6.16 – FDG PET for Inflammation and Infection, allowing local Medicare Administrative Contractors to determine coverage, which should improve coverage of FDG PET for cardiac sarcoidosis.
  • CMS finalized seven remote physiologic monitoring codes and laid out conditions under which they may be used following the COVID-19 public health emergency.


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