CMS Proposes New Medicare Physician Payment RuleOn July 13, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2022.
The public comment period will close on September 13, 2021.
For CY 2022, CMS is proposing a conversion factor of $33.58, a decrease of $1.31 from the CY 2021 PFS conversion factor of $34.89. This proposed conversion factor takes into account the proposed budget neutrality adjustment to account for changes in relative value units required by law, and expiration of the temporary 3.75% payment increase provided for CY 2021 by the Consolidated Appropriations Act, 2021.
AHCA/NCAL is still analyzing the proposed rule, but upon initial review, it appears that:
- Net Part B therapy payments will be reduced by approximately 2%, a significantly less cut than expected.
- Proposed coding policy changes are intended to resolve problems with reporting Part B physical and occupational therapy assistant services on claims. This will minimize the impact of implementing therapy assistant payment adjustments that start in CY 2022.
- Improvements to proposed policies and rates for SNF resident-related services, including portable x-ray, clinical lab, and vaccine administration.
- CMS proposes to extend the retention of all services added to the Medicare telehealth services list (including several physician and therapy services) on a temporary Category 3 basis beyond the COVID-19 public health emergency end date for further evaluation until the end of CY 2023, and favorably modify other related policies regarding coverage of other communications technology.
- CMS is proposing several modifications to the Medicare Shared Savings Program that may impact SNF providers participating in Accountable Care Organizations.
Staff contact: Angela Westhoff firstname.lastname@example.org