A Win for Physicians! Significant Medicare Cuts Have Been Averted

January 8, 2021

ISMS recently advocated to stop significant cuts for some physician specialties in the 2021 Medicare Physician Fee Schedule, which were poised to kick in on January 1. Thank you to the hundreds of ISMS members who contacted their federal lawmakers when we asked for assistance.

Good news! Due to the new federal comprehensive omnibus spending package, which was signed into law late last year, the AMA estimates that most specialties will now see either a neutral or positive change in total Medicare payments for 2021. The legislation will help to ease the impact of the fee schedule for physicians as the budget neutrality adjustments are now significantly reduced. 

How did the annual adjustments get out of whack?

In a nutshell, the Centers for Medicare and Medicaid Services (CMS) is required by flawed federal rules to make budget neutrality adjustments to the Medicare physician payment schedule when a change in relative value units (RVUs) generates a payment increase or decrease of $200 million. Significant increases in some specialty RVUs for office evaluation and management (E/M) services scheduled for 2021 were the driver behind the pending payment cuts for other specialties prior to the federal legislation.

If you have questions, please contact the ISMS Health Policy Research and Advocacy team by email.