Congress Mitigates 2021 Reduction in Medicare Payments for Physician Services

Published On: December 23, 2020Categories: Center Resources, Coding & Reimbursement, News, Policy Analysis

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Yesterday, Congress passed a comprehensive year-end bill that funds the federal government through FY 2021 and provides a new round of COVID relief and economic stimulus funds.  The bill also included changes to the 2021 Medicare Physician Fee Schedule, including two provisions which will mitigate the 10.2% reduction in Medicare’s payment rates (due to the 2021 conversion factor) included in the CMS final rule on MPFS. The bill provides:

  1. An increase of 3.75% to the MPFS conversion factor for all services in 2021
  2. A three year delay in payments for a new add-on evaluation and management (E/M) code (G2211), which was to account for visit complexity inherent in E/M visits
Taken together these provisions provide about $6 billion in funding for physician services and will significantly reduce the planned cut in Medicare payments.  CMS will need to recalculate the 2021 CF once the bill is signed by the President.

NAEC has prepared a summary of the highlights of the 2021 Medicare Physician Fee Schedule Final Rule and will update the charts showing national payment rates for neurology and E/M services once CMS publishes the revised 2021 conversion factor.  Please contact NAEC at info@naec-epilepsy.org with any questions.