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AMA pushes for a reprieve from budget neutrality, and CMS pushes back

The 2021 fee outlook emerged as a key point of discussion at the American Medical Association's (AMA) annual coding conference, with officials from the AMA and CMS offering divergent signals on what the scope of payment change may look like come Jan. 1.
In two early sessions at the CPT and RBRVS 2021 Annual Symposium, taking placing virtually from Nov. 18-20, viewers took home different messages on the fate of the expected 11% cut to the conversion factor, which goes a long way to determining Part B fees.
In August, CMS announced the severe cut to the conversion factor in the proposed 2021 Medicare physician fee schedule, and since then provider groups have urged the agency to backtrack on its plans. Groups are calling on CMS to avert the budget neutrality requirements that are influencing the rate cut after the upward revalution of E/M office visit services.
In welcome remarks this afternoon, Peter Smith, M.D., chair of the AMA/Specialty Society Relative Value Scale Update Committee (RUC), offered hope of a reprieve. "We're very hopeful that budget neutrality will be waived by CMS," Smith said.
Soon after, however, CMS officials signaled that it was not in their authority to act. In the session following the welcome remarks, four members of CMS' provider services team covered the 2021 Medicare Part B proposals, and Scott Lawrence, acting deputy director of physician practitioner services with CMS, noted that the agency is "required by statute" to maintain budget neutrality.
Lawrence also indicated that the fee outlook as stated in the proposed rule is likely to change.
"The numbers are going to be different in the final rule," due to finalized code values that may be different from those the agency proposed in August, Lawrence said. 
To what extent the 2021 fee change remains an open question. It is possible that Congress intervenes to waive budget neutrality. Or CMS could revise all or portions of the E/M code revaluations to avoid a significant reduction to the conversion factor.
Signals from today's session indicate that CMS won't act on its own to waive budget neutrality, even in light of the ongoing COVID-19 epidemic. But CMS officials appeared to leave the door open to revising proposed code increases, which may well result in different conversion factor than proposed.
Blog Tags: AMA, Breaking news, CMS
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