On January 11, Health and Human Services (HHS) Secretary Alex Azar extended the COVID-19 Public Health Emergency (PHE) declaration effective January 21, 2021, for an additional 90 days. This means that all of the telehealth and other waivers and flexibilities that have been implemented during the PHE will remain in effect until at least April 21, 2021.
In addition, the Consolidated Appropriations Act that was signed into law on December 27, 2020, included provisions that offset most of the 10.2 percent budget neutrality adjustment that had been slated to take effect for Medicare-covered services provided as of January 1, 2021. This changes the CY2021 conversion factor from $32.36 to $34.89 and is accomplished by:
- An increase in the payment schedule of 3.75 percent. This is applied across the board and without distinction to all payments under the Medicare physician payment schedule.
- Extending the two percent Medicare sequester moratorium through March 2021.
- Suspending payments for HCPCS code G2211 for three years (through the end of December 2023). G2211 is the complexity add on code for E/M services.
The Center for Medicare and Medicaid Services (CMS) has now confirmed that it is implementing the above provisions of this legislation and that there will be no delay in claims processing for 2021 services; that is, claims will be paid on time at the correct 2021 rates that reflect this legislation. A projected impact table by specialty and updated CY2021 audiology services fee schedule can be located here.
The Academy remains committed to fighting any cuts to Medicare reimbursement. We are pleased that based on the provisions in the legislation, the revised impact calculations show Audiologists potentially with a three percent increase in CY2021 Medicare reimbursement. This is based on the individual mix of services provided at each practice, but a much-welcomed improvement from the projected 6 percent decrease cuts to CY2021 Medicare reimbursement. If you should have any questions, please contact the Academy’s advocacy team.
The November 16, 2023, issue of MLN Matters provides the updated information to the Centers for Medicare and Medicaid Services (CMS) guidance “Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order.” The revised guidance now adds two new audiology codes to use with the AB modifier for direct access without a physician or non-physician…
Late November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule (MPFS) and 2024 Hospital Outpatient Prospective Payment System rules. The rules take effect January 1, 2024. MPFS High-Level Take-Aways Quality Payment Program (QPP) Provisions CMS has added two new measures (317 and 498) to the…
The proposed rule for the Medicare Physician Fee Schedule (MPFS) for calendar year 2024 (CY24) shows another year of Medicare cuts for most providers, as reflected in the extensive red of the audiology code table included with a recent update from the Academy. The projected impact is a -2 percent cut overall for audiology codes…