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Unraveling the Proposed 2021 Medicare Physician Fee Schedule (MPFS)

As we turn our sights to a new year, we take with us the experiences we’ve learned from surviving a global pandemic. It’s no surprise that the Public Health Emergency (PHE) has transformed healthcare delivery. These changes have also impacted healthcare reimbursement.

Medicare serves as the benchmark for policy development for healthcare reimbursement which makes it critical for healthcare professionals to follow their lead. CMS normally releases the final rule on or close to November 1 of each year. This year is unique in that CMS will delay the release of the 2021 final rule until December 1, 2020. With the obvious resources that are being devoted to COVID-19, it’s no surprise that a delayed release will occur.

Looking ahead to 2021; we now have a glimpse of changes to Conversion Factors (CF), Evaluation and Management changes (E&M), and how CMS proposes to value Work Relative Value Units (wRVUs) for next year. As outlined below, 50% of the impacted CPT/HCPCS codes will see an increase in applicable wRVUs.

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