On December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Medicare Physician Fee Schedule. CMS is finalizing its proposal to transition codes off the IPO list, indicating in the final rule that the list will be eliminated by 2024. This final rule establishes a Medicare coverage pathway to provide Medicare beneficiaries nationwide with faster access to new, innovative medical devices designated as breakthrough by the Food and Drug Administration (FDA). The Centers for Medicaid & Medicare Services (CMS) recently released the 2021 Physician Fee Schedule (PFS) Final Rule.The PFS Final Rule is scheduled to be published on December 28, 2020, but an unpublished version may be accessed here.CMS has also issued a fact sheet, which overviews the changes made by the 2021 PFS Final Rule. The correction reminded practitioners the universe of RPM-related codes is not limited to just CPT codes 99091, 99453, 9454, 94557, and 99458. The Centers for Medicare and Medicaid Services (CMS) released the Calendar Year 2021 Medicare Physician Fee Schedule and Quality Payment Program final rule on Dec. 1, 2020.. The Centers for Medicare and Medicaid Services (CMS) on Dec. 1 released the 2021 Medicare Physician Fee Schedule final rule, addressing Medicare payment and quality provisions for physicians in 2021.Physicians will see a conversion factor decrease on Jan. 1, 2021… The rule is effective January 1, 2021 and applies to Medicare providers including clinical social workers (CSWs). 2021 Quality Payment Program Final Rule Resources (ZIP 1MB) 2020 Quality Payment Program Final Rule Executive Summary (PDF 380KB) 2020 Quality Payment Program Final Rule FAQs ... A federal government website managed and paid for by the U.S Centers for Medicare & Medicaid Services. On Jan. 14, 2021, the Centers for Medicare & Medicaid Services (CMS) published a final rule creating a new Medicare coverage and reimbursement pathway for “breakthrough” medical devices. CMS published the Interoperability and Patient Access Final Rule in the Federal Register on March 4, 2019, the pre-publication text of the final rule was released on March 9, 2020, and the final rule was published in the Federal Register on May 1, 2020. In May of 2020, The United States Department of Health and Human Services (HHS) Office of the National Coordinator for Health Information Technology (ONC) and Centers for Medicare and Medicaid Services (CMS) released two final rules, focusing on implementing the interoperability and patient access provisions of the 21st Century Cures Act (2015). Known as the Medicare Coverage of Innovative Technology (MCIT) pathway, this coverage mechanism provides national Medicare coverage for a period of four years after the date of FDA approval. On September 2, 2020 CMS published the Fiscal Year (FY) 2021 Medicare Hospital Inpatient Prospective Payment System for Acute Care Hospitals and Long-term Care Hospital Prospective Payment System Final Rule. The rules are effective as of January 2021 and will be enforced by July 2021. After tabling the subject for a year, CMS finalized rulemaking in their 2021 ACA NBPP Final Rule: CMS is starting with approximately 300 services for removal from the IPO list in 2021, primarily musculoskeletal services. CMS Reimbursement •The reimbursement per RVU is being adjusted for 2021 –The budget neutrality adjustment, as required by law, accounts for changes in RVUs including significant increases for E/M visit codes –CY 2021 PFS conversion factor is $32.41, a decrease of $3.68 from the CY 2020 PFS conversion factor of $36.09. This proposed rule was never finalized due to a conflict and the resulting confusion with an IRS notice from 2004 outlawing the contribution of coupon assistance towards deductibles in high-deductible/HSA plans. The rule would make permanent certain telehealth and workforce flexibilities provided during the public health emergency, establish payment rates for physicians and other health care professionals for 2021, and … Editor’s Note: On January 19, 2021, after the date this article was published, CMS issued a correction clarifying its original commentary in the 2021 Physician Fee Schedule Final Rule. For more information on the finalized changes for the 2021 program year, visit the Federal Register and view this fact sheet.