Psychologists and many other healthcare specialists will face steep cuts in Medicare payment rates for services in 2021, due to an almost 11% cut to the conversion factor used to calculate reimbursement rates. The Centers for Medicare and Medicaid Services (CMS) released its proposed Physician Fee Schedule for 2021 on Aug. 3 including a new, updated coding structure for routine outpatient visits—known as evaluation and management (E/M) services—provided by physicians and certain nonphysician providers. The new E/M billing codes will be simplified, and paid at a higher rate.
APA has made preventing these Medicare reimbursement cuts a priority, and psychologists can help by contacting their members of Congress to ask them to waive budget neutrality for implementation of the new E/M codes.
APA has been raising the alarm with CMS and Congress since learning of the new Medicare payment policies for E/M services and their effect on psychologists’ payments since 2019. The day after the proposed rule was released, APA joined a wide array of both physician and nonphysician provider organizations in issuing a statement calling for waiving Medicare’s budget neutrality requirements in implementing the new E/M codes. On Aug. 11, Congressman Bobby Rush (D-Ill.) sent a letter to House Speaker Nancy Pelosi and House Minority Leader Kevin McCarthy (PDF, 140KB), signed by 93 of his House colleagues, urging that the budget neutrality requirement be waived for implementation of the new E/M codes in order to protect healthcare providers from “devastating” cuts that will ultimately decrease access to care for Medicare beneficiaries.
APA is developing comments to CMS addressing this and other issues in the proposed rule, and soon will be sharing these comments and suggested language for psychologists to use in contacting the agency.
For more information, contact Laurel Stine, JD, and Scott Barstow.