AMA calls for modifications to the proposed Medicare 2021 fee schedule

October 7, 2020

The organization says the Medicare fee schedule should reflect changes brought on by the ongoing COVID-19 coronavirus pandemic.

The American Medical Association (AMA) says the proposed Medicare 2021 fee schedule should be modified to reflect changes brought on by the ongoing COVID-19 coronavirus pandemic.

In detailed comments submitted to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma, the AMA warned that some proposed regulations in the fee schedule would hurt many practices already wounded by the COVID-19 coronavirus pandemic.

“During the pandemic, physicians have responded heroically in the face of challenges to keeping their practices open and treating their patients,” AMA President Susan R. Bailey, MD, says in a news release. “COVID-19 has exposed weaknesses in our health care system as well as opportunities for improvement. Our comments are intended to ensure physicians can continue providing the highest quality care for Medicare beneficiaries during and after this public health emergency. To achieve this, we recommend that CMS prevent the steep budget neutrality cuts that are pending and continue the forward-looking changes for telehealth patients.”

The association says that it supports CMS’ implementation of a new office visit policy taking effect Jan. 1 and believes that it will reduce administrative burdens but is deeply concerned about corresponding budget neutrality cuts in the face of the hammering physicians have taken in revenue throughout the pandemic. The proposed fee schedule will result in a 5.5 percent cut in physician payment and additional recommendations would kick that cut up to 11 percent. AMA says CMS should waive budget neutrality to avoid the cuts, the release says.

Other modifications AMA suggests include:

  • CMS should treat all physicians fairly by implementing the office visit increases into the surgical global payments.
  • CMS should make permanent several telehealth services which remove geographic and site-of-service barriers and continue covering services through the end of the year following the year in which the pandemic end. These services should also include audio-only visits.
  • CMS should implement and pay for new CPT code 99072 which describe the additional supplies and clinical staff required for evaluation, treatment or procedural services during a public health emergency
  • CMS should continue the much-needed flexibilities introduced to the Medicare Quality Payment System implemented during the pandemic into the next year

“Physicians have made unique sacrifices during the pandemic,” Bailey says in the release. “They have faced personal dangers often without enough personal protective equipment. CMS has given physicians flexibility so they can continue seeing patients. We need to keep these changes in place as COVID is still presenting challenges every day.”