On April 13, 2021, the United States House of Representatives passed H.R. 1868 which extends the pause on the 2% sequestration reduction through the end of calendar year 2021. This legislation was passed by the United States on March 25, 2021. President Biden signed this legislation into law on April 14, 2021.
Breaking news from the Centers for Medicare and Medicaid Services. Per CMS:
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On March 25, 2021, the United States Senate passed legislation that would continue to pause the 2% sequestration reduction through the end of 2021. That is the good news. The bad news is the United States House of Representatives will not take up the legislation until the week of April 12th.
While we do expect the House of Representatives to pass the legislation and President Biden to sign it into law, the 2% sequestration reduction will resume with dates of service on and after April 1, 2021 until this occurs. What is unknown at this time is will the Centers for Medicare and Medicaid Services (CMS) process claims with the 2% reduction for dates of service on and after April 1, 2021 and then once legislation is passed and signed into law, go back and reprocess all of the claims and pay the providers the difference or will CMS hold April claims pending the outcome of the legislation in the House of Representatives?
On December 21, 2020, the United States Senate and United States House of Representatives passed legislation that will have a financial impact on outpatient physical, occupational and speech therapy services thru December 31, 2023. President Trump signed the legislation into law on December 27, 2020. In this article, I will provide information on the following topics:
- Conversion factor change for calendar year 2021 that will impact payment for outpatient physical, occupational and speech therapy services under the Medicare Physician Fee Schedule.
- Extension of temporary suspension of Medicare sequestration
- Extension of the Work Geographic Index Floor minimum of 1.0
- Places a moratorium on the payment for G2211
- How does G2211 impact payment for outpatient therapy services?
- In simple terms, what is the expected payment adjustment for outpatient therapy services in 2021 compared to 2020?
Medicare Physician Fee Schedule (MPFS) and the Conversion Factor
Extension of Temporary Suspension of Medicare Sequestration
Extension of the Work Geographic Index Floor Minimum of 1.0
Places a Moratorium on the Payment for G2211
How Does G2211 Impact Payment for Outpatient Therapy Services?
In simple terms, what is the expected payment adjustment for outpatient therapy services in 2021 compared to 2020?
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