AANEM News Express

AANEM News Express

2020 Omnibus Bill Averts Expected Medicare Cuts for Neurology and PM&R

The final COVID-19 relief legislation of 2020 was passed by Congress late on December 21st. Included in this massive 5,593 page omnibus bill are several provisions expected to have substantial, positive impacts for physicians, including significantly softening what was expected to be a large reduction to the Medicare conversion factor in 2021.

According to Medicare's Final Rule on the Physician Fee Schedule for 2021, the Medicare conversion factor was set to be cut by 10.2%, largely due to the introduction of a new code, changes in E/M coding and billing, and budget neutrality rules. This reduced conversion factor was likely to have a substantial negative impact on many physicians, including most AANEM members. The AANEM, along with the AMA and nearly every physician membership organization across the nation, reached out to Congress, imploring them to avert such drastic cuts to physician practices, especially in the midst of the COVID-19 public health emergency (PHE). The 2020 omnibus bill mitigates some of the impact that the new E/M codes were slated to have on reimbursement by delaying implementation of HCPCS code G2211 (an add-on code to be used to account to visit complexity inherent in E/M visits), as well as providing an additional $3 billion in funding to raise Medicare reimbursement up 3.75% from the previously announced conversion factor. Additionally, the bill also suspended the 2% Medicare Sequestration cut, pushing it out until March 31, 2021, instead of the scheduled December 31, 2020 start date.

Based on a preliminary analysis by the AMA, these changes should result in a roughly 7% increase in reimbursement for neurologists and a 3% increase for physical medicine & rehabilitation physicians across the board. AANEM policy staff is currently working to overhaul its RVU analysis of the codes most frequently used by NM and EDX physicians based on this latest development and hopes to have those numbers out to the membership soon.

In addition to the provisions related to Medicare reimbursement, the omnibus bill also included additional funding for: the Provider Relief Fund, the expansion of various telehealth programs, graduate medical education relief funding, as well as funding for several other public health initiatives. The legislation also includes a ban on surprise medical billing beginning in 2022.

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