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CMS Proposes Updates to Medicare Physician Fee Schedule

The Centers for Medicare and Medicaid Services (CMS) issued the Calendar Year (CY) 2021 Medicare Physician Fee Schedule Proposed Rule on Aug. 4th. The proposal would update and revise Medicare’s Physician Fee Schedule (PFS) for services furnished on or after Jan. 1, 2021. The PFS is also used to determine Medicare Part B payment amounts for therapy services, and the proposed revisions are estimated to decrease payment for therapy services by more than 9 percent.

The proposed Medicare PFS would also:

  • extend the availability of certain telemedicine services beyond the end of the public health emergency;
  • update evaluation and management coding and billing guidance;
  • make changes to professional scopes of practice relating to supervision of diagnostic tests, pharmacist services, therapy assistants furnishing maintenance therapy, medical record entry and verification, and payments for services of teaching physicians to resident physicians;
  • revise Medicare coverage for Opioid Use Disorder treatment services; and
  • make changes to the Quality Payment Program which would be gradually phased in during CY 2021.

CMS is hosting a listening session this Thurs., Aug. 13th from 1:30 to 3 p.m. ET on the proposed changes, for which interested parties may register. During the session, CMS will briefly cover the provisions of the proposed rule and address questions. CMS encourages stakeholders to review the following materials prior to the call:

Comments on the proposed rule will be accepted through Oct. 5, 2020.

Contact: Dan Heim, dheim@leadingageny.org, 518-461-2934