New Year Brings Significant Changes To Medicare Physician Fee Schedule

The Medicare Physician Fee Schedule Final Rule for Calendar Year 2021 (the Final Rule) issued by the Centers for Medicare & Medicaid Services (CMS) on December 1, 2020, and published in the Federal Register on December 28, 2020, made significant and far-reaching changes to the Medicare Physician Fee Schedule (PFS). In the Final Rule, which went into effect on January 1, 2021, CMS implemented changes to streamline the reporting process for office and outpatient evaluation and management (E/M) services and increased the relative value units (RVUs) for E/M services.

To account for the increase in RVUs for E/M services and still maintain compliance with the budget neutrality adjustment, CMS decreased the 2021 conversion factor to $32.41, down $3.68 (or 10%) from 2020. CMS also implemented a number of changes reflecting permanent shifts to the healthcare system as a result of COVID-19 by expanding reimbursable telehealth services beyond the duration of the Public Health