The Centers for Medicare & Medicaid Services (CMS) released the 2021 Medicare Physician Payment Schedule Final Rule on Dec. 1. AMA staff continue to analyze the rule and will release a detailed summary shortly. Physicians are encouraged to check your numbers and plan accordingly for the year. Here are the top lines:

  • Physicians will report office and outpatient Evaluation and Management (E/M) visits based on either medical decision-making or physician time.
  • The federal CMS adopted the relative value recommendations made by the AMA/Specialty Society RVS Update Committee (RUC) for the office and outpatient E/M visits, which will lead to payment increases, but did not apply RUC-recommended values to visits bundled into global surgical payments.
  • Due to budget neutrality requirements, the CY 2021 physician payment conversion factor is $32.41, a decrease of $3.68 from the CY 2020 conversion factor of $36.09. This is a decrease of 10.2%. The CY 2021 anesthesia conversion factor is $20.04, a decrease of $2.15 from the CY 2020 conversion factor of $22.20. Redistributions will be significant, with family medicine increasing by 13% and many specialties that do not perform office visits decreasing by 8% or more.

The AMA will continue to advocate for congressional action to mitigate losses for physicians and practices, especially during the current public health crisis. More information: www.ama-assn.org/cpt-office-visits


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