Thread by @EdGainesIII

@CMSGov issued ‘21 Medicare #Physician Fee Schedule Proposed Final Rule w/ comment period & the news is not good —the Medicare “conversion factor” which applies to physicians & other clinicians is proposed to decline >10.5% in ‘21—happy reading > 1350 pgs
cms.gov/files/document…

2/ Major expansion of #telehealth per the press release, details to follow.

3/ major hospital based specialists will be significantly cut in’21 by Medicare in the midst of a global pandemic—@EmergencyDocs -6%, anesthesiologists-8%, radiology -11% and IR -9%. Congress & @CMSGov here they come—Table 90, page 899.

2A/ @CMSGov proposed rule presser states that #telehealth reimbursements for #ED E/Ms would continue until the end of the year of the #PHE, so if the ‘20 PHE is extended until ‘21 then Medicare reimbursements would be extended until 12/31/21.

4/ For those who may question why physicians specialties & trade groups spend so much time & $ on advocacy + regulatory issues--here's your Exhibit A--had CMS not agreed w/ @ACEPNow & @EDPMA calls for "re-balancing" the E/M codes, then the cut to EM could've been ~>10%, per CMS:

5/ So the collective "House of Medicine" ask is neither new 2 the specialty societies & has the beauty of simplicity; recall that the CMS pie is $1.00, designed as a zero sum game--give 1 X & you take away from Group Y--we ask 4 Congress to remove "budget neutrality"--0 zero sum.

6/ In almost 3 decades, I’ve never seen conversion factor (CF) cut over 10% in 1 yr.—good news that @ACPinternists is supporting advocacy in Congress to lift “budget neutrality”—without that support as Dr. Fougner points the @CMSGov proposal pits 1 specialty vs. the other.

7/ Note that the -10.6% on the @CMSGov conversion factor (CF) impacts @EmergencyDocs procedures to the full -10.6% as the increase in the CPT 99283-85 E/M codes will not offset the full -CF on “non-E/M” codes—now 90% of your reimbursement is from the E/M but important to note.

8/ Add’l points made in @JeffreyLDavis44 of @ACEPNow in his “Regs & Eggs” blog— #ED E/M codes will be paid during the #PHE & assuming the PHE is extended into ‘21 the CPT 99281-83 codes will be reimbursed thru the end of ‘21 (not Levels IV & V for #telehealth given complexity)