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2021 Physician Fee Schedule Impact

Finalized Changes in Medicare Payments

The 2021 Medicare Physician Fee Schedule (PFS) final rule issued on December 2, 2020 cut a broad array of office-based specialists as a result of so-called “budget-neutral” effects of the CMS policy to provide additional reimbursement for evaluation and management services.  These cuts exacerbated the access crisis caused by the COVID-19 public health emergency and posed a particular threat to seniors and other Americans with conditions that required the care of a specialist.

 

The table below describes all specialties cut more than 5% in the 2021 PFS Final Rule.  It is important to note that the impact table below taken from the 2021 PFS Final Rule does not disaggregate specialty impact by site-of-service and, as a result, masks the true (even worse) impact to the office-based setting.  


As a result of the Consolidated Appropriations Act of 2021, these cuts were phased-in with a 3% cut to the PFS conversion factor occurring in 2021, an upcoming 3.75% cut to the PFS conversion factor slated for January 1, 2022, and another similar cut slated for January 1, 2024.  

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USPA’s vision is for a Physician Fee Schedule that provides payment stability for office-based specialists and fundamental reform of the so-called "budget-neutrality" provision. 

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