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2021 Physician Fee Schedule Impact

Finalized Changes in Medicare Payments

The 2021 Medicare Physician Fee Schedule (PFS) final rule issued on December 2, 2020 cut a broad array of office-based specialists as a result of so-called “budget-neutral” effects of the CMS policy to provide additional reimbursement for evaluation and management services.  These cuts exacerbated the access crisis caused by the COVID-19 public health emergency and posed a particular threat to seniors and other Americans with conditions that required the care of a specialist.

The table below describes all specialties cut more than 5% in the 2021 PFS Final Rule.  It is important to note that the impact table below taken from the 2021 PFS Final Rule does not disaggregate specialty impact by site-of-service and, as a result, masks the true (even worse) impact to the office-based setting.  

As a result of the Consolidated Appropriations Act of 2021 and subsequent legislation, these cuts were phased-in with a 3% cut to the PFS conversion factor occurring in 2021, a 0.75% cut to the PFS conversion factor on January 1, 2022, an upcoming 3% cut to the PFS conversion factor on January 1, 2023, and another 3% cut to the conversion factor slated for January 1, 2024.  

Taking Action

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Our Mission

OBFA’s vision is for a Physician Fee Schedule that provides payment stability for office-based specialists and fundamental reform of the so-called "budget-neutrality" provision. 

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Find the latest news, Congressional letters, policy correspondence, press releases, polling, and other important information.

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USPA is gearing up for action on multiple fronts. If you think your organization would like to contribute towards this important effort, contact us here so we can learn more about each other.

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