CMS Releases CY 2021 Physician Fee Schedule Final Rule

Members & Publications

December 1, 2020

On December 1, the Centers for Medicare and Medicaid Services (CMS) released the 2021 Physician Fee Schedule Final Rule.  Your Academy submitted comments on the Physician Fee Schedule Proposed Rule earlier this fall.  This final rule reflects several policies that have been modified based on comments as well as policies that have been finalized as proposed.  As we continue to review the details of the rule, we will provide updates to AAPM&R members via email.

Our initial review has identified several key takeaways from the final rule:

  • CMS has finalized a conversion factor of $32.41 for calendar year 2021, a decrease of $3.68 or 10.2% from the 2020 conversion factor.
  • CMS has finalized its proposal to implement revised office and outpatient evaluation and management (E/M) codes effective January 1, 2021. Further, CMS has finalized increased work RVUs for office and outpatient E/M.
  • CMS has finalized an expansion of the list of services which can be provided via telehealth. The list now includes codes for nursing facility discharge day management as well as physical and occupational therapy services.
  • CMS has finalized its proposal to allow nurse practitioners, clinical nurse specialists, physician assistants, certified nurse anesthetists, and certified nurse-midwives to supervise the performance of diagnostic tests within their scope of practice and state law.
  • CMS has finalized several proposed updates to the Quality Payment Program for 2021.

Review the CMS Fact Sheet for further detailed information and stay tuned for additional details on the final rule coming soon. You may also email with any questions.

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.