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You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released this morning. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.
Influencing the substantial decrease to the CF are the projected pay increases to the core set of E/M office visit codes (99202-99215). CMS confirmed that the E/M office visit codes remain on track for their first major overhaul in 25 years, according to the proposed 2021 Medicare physician fee schedule.
The Quality Payment Program is delaying a major overhaul planned for 2021: Its MVP (MIPS Value Pathways) upgrade, which was meant to move participants “away from siloed activities and measures and towards an aligned set of measures that are more relevant to a clinician’s scope of practice,” has been delayed due to “stakeholder concerns” and COVID-19. Instead, CMS will make “additions to the framework’s guiding principles and development criteria” for 2022.
CMS and the CDC agree: If your practice is testing for COVID-19, a physician or qualified health care professional should counsel the tested patients about what to do and what to expect while they wait for results, and they can be paid for the counseling.
Part B News recently explored the ramifications of the recenlty-published final 1557 rule and the Bostock Supreme Court decision that seems to invalidate its effect on medical practice. Here with further thoughts on the subject is Melodie Hengerer, of counsel with Baker Donelson in Baltimore.
Get ready to update your Advance Beneficiary Notice of non-coverage (ABN) forms. Medicare has released a new form and instructions that will be mandatory on Aug. 31. The new forms have a 06/30/2023 expiration date in the footer and your practice may use them now.


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