ACP Action Alert: Tell Congress not to delay CMS's Final 2021 Medicare Payment Increases for Outpatient Visits! Time is of the Essence!
Dec. 8 Update: With this session of Congress winding down in a matter of a few weeks, we are urging members to please reach out to your lawmakers on this important issue, if you have not already. We have added a call script in addition to a sample letter for your convenience so please act now!
On December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released the final 2021 Medicare Physician Fee Schedule (MPFS). ACP is very pleased that it will increase payments for many office visits and related E/M services, create new “G” codes that will allow physicians to get additional payments for complex visits and visits that take more time than usual (prolonged services), and increase payments for care coordination. ACP specifically supports, and calls on Congress to support, CMS’s decision to implement a new code to better recognize a particularly complex patient visit. Code G2211 will allow physicians to account for services like chronic disease management tracking, reviews of consult or lab reports, medication-related monitoring and safety outside of patient visits, and physician input at assisted living or nursing homes.
These payment increases are essential to primary care physicians, whose practices have been hit especially hard by the COVID-19 pandemic. We need your continued help to ensure that Congress does not delay, or phase-in these improvements over several years instead of fully implementing them on January 1, as part of legislation to hold other physician services harmless from budget neutrality payment reductions (see background below for details). In a letter to congressional leaders, ACP urged Congress to support implementation of these increases as scheduled without delay. ACP also issued a similar statement.
While many physicians and specialties providing undervalued E/M services will see major improvements in overall payments in the final 2021 MPFS, some will see reductions. ACP is supportive of requests to Congress to waive budget neutrality for the 2021 Fee Schedule, provided that this would not result in a delay or in any way undermine CMS’s decision to fully implement the E/M increases and other improvements on Jan. 1.
Action Requested: Follow the prompts, and send a letter to your members of Congress urging them to support the scheduled Jan. 1 payment increases for primary and comprehensive care in the MPFS. A sample letter has been provided for you that you can personalize. Time is of the essence, because Congress will be deciding in the next few days and weeks on a final bill to address the BN cuts and the improvements for outpatient visits.