The Centers for Medicare & Medicaid Services (CMS) released the final 2021 Medicare physician fee schedule (PFS) rule this evening, which includes changes to the Merit-based Incentive Payment System (MIPS) and alternative payment model (APM) participation options and requirements for 2021. The final rule:
For more information, review the physician payment fact sheet and QPP zip file associated with the 2021 final PFS. MGMA will analyze the final rule and provide a detailed analysis as a member benefit. MGMA will also provide further education on this complex regulation during our 2021 Medicare Outlook member-benefit webinar on Thursday, Dec. 10 at 1 pm ET.
- Sets the CY 2021 PFS conversion factor at $32.41 and the CY 2021 national average anesthesia conversion factor at $20.0547. MGMA is advocating for a legislative fix to address the reimbursement cuts resulting from the lower conversion factor;
- Generally confirms E/M office visit documentation guidelines and payment changes finalized in the 2020 PFS;
- Modestly expands telehealth coverage; and
- Establishes MIPS reporting requirements for 2021 and sets the performance threshold at 60 points.