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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.
 

Citing the COVID-19 crisis, CMS announced some relief for quality reporting and data submission related to the Quality Payment Program (QPP), the Merit-based Incentive Payment System (MIPS) and the Medicare Shared Savings Program Accountable Care Organizations (ACOs).

If you are one of the qualifying APM participants (QPs) who earned a lump sum incentive payment for your hard work for an advanced alternative payment model (APM) in 2017, congratulations!
 
The vast reshaping of E/M documentation standards and payment changes took a significant step closer to reality as CMS put a stamp of approval on its previous proposals to overhaul how medical practices report office and outpatient E/M services 2021.
 
Next year many providers will see a modest boost to the conversion factor that, along with relative value units (RVUs), dictates pay rates across all services in the Medicare physician fee schedule. The conversion factor will rise to $36.0896 in 2020, which CMS previously proposed, from $36.0391 in 2019, according to the final fee schedule. However, the anesthesia conversion factor will decrease to $22.2016 in 2020 from $22.2730 this year. That’s a drop from the proposed anesthesia conversion factor of $22.2774.
 
Recently Part B News gave you a heads-up on materials that you should store in case CMS audits your MIPS attestations. We got some added detail on the situation in a conversation with Lori Foley, managing principal with the PYA consultancy in Atlanta.

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