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The 2021 Medicare Proposed Physician Fee Schedule was Released Today

The 2021 Medicare Proposed Physician Fee Schedule was Released Today August 4, 2020

CMS released the 2021 Proposed Physician Fee Schedule today. The 1,353 page document contains numerous, important proposals including:

  • Expansion of telehealth including revision of frequency limitations for certain services
  • No delay for E/M revisions
  • Continued expansion of coverage of services provided by non-physician practitioners 
  • Continued expansion of coverage of teaching physician and resident services
  • Decrease in the conversion factor to $32.26 from $36.09
  • Payment increases for certain services including: ESRD monthly capitation, transitional care management, emergency department, therapy evaluations and psychiatric services
  • Removal of 9 National Coverage Determinations (NCD) including: apheresis, cytogenic studies, implantation of gastroesophageal reflux devices and histocompatability testing
  • Waiver of the 60-day delayed effective date for the the final rule which will be replaced with a 30-day delay in effective date. 

We recommend you read the entire Proposed Rule in order to identify all of the changes applicable to your practice.  The HBE team is available to assist you with the implementation of these important changes as well as provide assistance in preparing your staff through education and training. 

The Proposed Rule is available here: https://www.cms.gov/medicaremedicare-fee-service-paymentphysicianfeeschedpfs-federal-regulation-notices/cms-1734-p

The press release may be viewed at: https://www.cms.gov/newsroom/press-releases/trump-administration-proposes-expand-telehealth-benefits-permanently-medicare-beneficiaries-beyond

The fact sheet is available at: https://www.cms.gov/newsroom/fact-sheets/proposed-policy-payment-and-quality-provisions-changes-medicare-physician-fee-schedule-calendar-year-4

HBE’s team of coding and compliance experts is available to assist you with external reviews of your documentation, coding and reimbursement as well as providing customized education and training for your staff. We are also available to provide assistance with conducting risk assessments, internal investigations and policy and procedure development.

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