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 and subsequent legislation, these cuts were phased-in with a 3% cut to the PFS conversion factor occurring in 2021, a 0.75% cut to the PFS conversion factor on January 1, 2022, an upcoming 3% cut to the PFS conversion factor on January 1, 2023, and another 3% cut to the conversion factor slated for January 1, 2024.
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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